Bleeding complications in patients with coronary stents during non-cardiac surgery |
| |
Authors: | Pierre Albaladejo Hélène Charbonneau Charles-Marc Samama Jean-Philippe Collet Emmanuel Marret Vincent Piriou Celine Genty Jean Luc Bosson |
| |
Institution: | 1. Department of Anaesthesia and Intensive Care Medicine, Grenoble University Hospital, Grenoble, France;2. ThEMAS, TIMC, UMR, CNRS 5525, Univ. Grenoble Alpes, France;3. Department of Anaesthesia and Intensive Care Medicine, Assistance Publique Hôpitaux de Paris, Cochin University Hospital, Paris, France;4. Cardiology Institute, Assistance Publique Hôpitaux de Paris, La Pitié-Salpêtrière University Hospital, Paris, France;5. Department of Anaesthesiology, Institut Hospitalier Franco-Britannique, Levallois, France;6. Department of Anaesthesia and Intensive Care Medicine, Lyon-South University Hospital, Bron, France |
| |
Abstract: | IntroductionPatients with coronary stents often undergo non-cardiac invasive procedures. These are often associated with thrombotic and/or hemorrhagic complications. The type of procedure, perioperative antiplatelet therapy, and other patient-related factors influence the risk of postoperative haemorrhage. Our objective was to analyze the postoperative risk factors for hemorrhagic complications and to determine the impact of antiplatelet and anticoagulant therapy strategies on postoperative bleeding risk in patients with coronary stents undergoing non-cardiac surgery.Patients and MethodsProspective, multicentre observational cohort study of 1134 consecutive patients with coronary stents undergoing non-cardiac surgery between April 2007 and April 2009. The primary outcome measure was the occurrence of an hemorrhagic complication during the first 30 days following the surgery or intervention.ResultsAmong the 1134 patients evaluated, 108 (9.5%) experienced a postoperative hemorrhagic complication (with a median time to occurrence of 5.3 days). These complications were considered major, involved the operative site, and required reoperation in 92 (85.2%), 92 (85.2%), and 20 (18.5%) of patients, respectively. Mortality in patients with a haemorrhagic complication was 12% (n = 13). Independent postoperative factors associated with haemorrhagic complications were identified as a high and intermediate bleeding risk procedure and the use and dose of anticoagulants. When interrupted before the procedure, resumption of antiplatelet treatment was delayed in patients developing early postoperative hemorrhagic complications.ConclusionPatients with coronary stents who undergo surgery are at high risk for hemorrhagic complications. |
| |
Keywords: | ASA Acetylsalicylic acid CI confidence interval DVT Deep Vein Thrombosis LMWH Low Molecular Weight Heparin OR Odds ratio PCI Percutaneous coronary intervention RECO (&ldquo Registre des patients porteurs d&rsquo Endoprothè ses Coronaires Opé ré s&rdquo ) = French national registry of patients with coronary stents undergoing an invasive intervention |
本文献已被 ScienceDirect 等数据库收录! |
|