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Perioperative Antiplatelet Strategy in Patients Undergoing Noncardiac Surgery Within One Year After Percutaneous Coronary Intervention
- Title
- Perioperative Antiplatelet Strategy in Patients Undergoing Noncardiac Surgery Within One Year After Percutaneous Coronary Intervention
- Authors
- Lee; Sang-Hyup; Kim; Choongki; Shin; Sanghoon; Hyeongsoo; Park; Jong-Kwan; Oh; Seung-Jin; Ahn; Sung Gyun; Cho; Sungsoo; Oh-Hyun; Moon; Jae Youn; Won; Hoyoun; Suh; Yongsung; Yun-Hyeong; Jung Rae; Byoung-Kwon; Yong-Joon; Seung-Jun; Hong; Sung-Jin; Dong-Ho; Chul-Min; Byeong-Keuk; Ko; Young-Guk; Choi; Donghoon; Myeong-Ki; Jang; Yangsoo; Jung-Sun
- Ewha Authors
- 김충기; 신상훈
- SCOPUS Author ID
- 김충기; 신상훈
- Issue Date
- 2023
- Journal Title
- American Journal of Medicine
- ISSN
- 0002-9343
- Citation
- American Journal of Medicine vol. 136, no. 10, pp. 1026 - 1.03E04
- Keywords
- Antiplatelet therapy; Net adverse clinical events; Non-cardiac surgery; Percutaneous coronary intervention
- Publisher
- Elsevier Inc.
- Indexed
- SCIE; SCOPUS
- Document Type
- Article
- Abstract
- Background: The optimal antiplatelet therapy (APT) for patients undergoing non-cardiac surgery within 1 year after percutaneous coronary intervention (PCI) is not yet established. Methods: Patients who underwent non-cardiac surgery within 1 year after second-generation drug-eluting stent implantation were included from a multicenter prospective registry in Korea. The primary endpoint was 30-day net adverse clinical event (NACE), including all-cause death, major adverse cardiovascular event (MACE), and major bleeding events. Covariate adjustment using propensity score was performed. Results: Among 1130 eligible patients, 708 (62.7%) continued APT during non-cardiac surgery. After propensity score adjustment, APT continuation was associated with a lower incidence of NACE (3.7% vs 5.5%; adjusted odds ratio [OR], 0.48; 95% confidence interval [CI], 0.26-0.89; P = .019) and MACE (1.1% vs 1.9%; adjusted OR, 0.35; 95% CI, 0.12-0.99; P = .046), whereas the incidence of major bleeding events was not different between the 2 APT strategies (1.7% vs 2.6%; adjusted OR, 0.61; 95% CI, 0.25-1.50; P = .273). Conclusions: The APT continuation strategy was chosen in a substantial proportion of patients and was associated with the benefit of potentially reducing 30-day NACE and MACE with similar incidence of major bleeding events, compared with APT discontinuation. This study suggests a possible benefit of APT continuation in non-cardiac surgery within 1 year of second-generation drug-eluting stent implantation. © 2023 Elsevier Inc.
- DOI
- 10.1016/j.amjmed.2023.06.003
- Appears in Collections:
- 의료원 > 의료원 > Journal papers
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