Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.
Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
Eur J Clin Invest. 2018 Dec;48(12):e13030. doi: 10.1111/eci.13030. Epub 2018 Oct 8.
In the risk assessment of patients considered for non-cardiac surgery and with recent coronary stent implantation, coronary drug-eluting stent implantation procedure characteristics may be taken into account. We aimed to evaluate associations between coronary drug-eluting stent implantation procedure characteristics and the risk of myocardial infarction and all-cause death within 30 days after non-cardiac surgery.
Patients with coronary drug-eluting stents were identified using the Western Denmark Heart Registry. Surgical procedures performed after stent implantation were detected using the Danish National Patient Registry. We used registry-based detection of myocardial infarction and all-cause death.
Of 22 590 patients treated with drug-eluting stents between 2005 and 2012, 4046 underwent non-cardiac surgery within 1 and 12 months after stent implantation. We found no significant association between the risk of myocardial infarction or all-cause death within 30 days after surgery and number of arteries treated (1 [reference] vs more), number of lesions treated (1 [reference] vs more), segments treated (left main and proximal left anterior descending artery vs other [reference]), total stent length (<20 mm [reference] vs ≥20 mm), number of stents (1 [reference] vs >1) and largest balloon diameter (≥3 mm [reference] vs <3 mm). All-cause death, but not myocardial infarction, risk was lower among patients treated with first-generation vs second-generation stents (odds ratio 0.58).
We identified no significant associations between stent implantation procedure characteristics and risk of myocardial infarction or all-cause death among patients undergoing non-cardiac surgery. All-cause death was lower with first- vs second-generation drug-eluting stents.
在考虑非心脏手术且近期接受过冠状动脉支架植入术的患者的风险评估中，可考虑冠状动脉药物洗脱支架植入术的特征。我们旨在评估冠状动脉药物洗脱支架植入术特征与非心脏手术后 30 天内心肌梗死和全因死亡风险之间的关联。
使用丹麦西部心脏注册中心识别接受冠状动脉药物洗脱支架治疗的患者。使用丹麦国家患者登记处检测支架植入后进行的手术程序。我们使用基于登记的心肌梗死和全因死亡检测。
在 2005 年至 2012 年期间接受药物洗脱支架治疗的 22590 例患者中，有 4046 例在支架植入后 1 至 12 个月内接受了非心脏手术。我们发现手术后 30 天内心肌梗死或全因死亡的风险与治疗的动脉数量（1[参考]比更多）、治疗的病变数量（1[参考]比更多）、治疗的节段（左主干和近端左前降支比其他[参考]）、总支架长度（<20mm[参考]比≥20mm）、支架数量（1[参考]比>1）和最大球囊直径（≥3mm[参考]比<3mm）之间没有显著关联。与第一代支架相比，第二代支架治疗的全因死亡率（但非心肌梗死）较低（比值比 0.58）。
我们没有发现支架植入术特征与非心脏手术患者的心肌梗死或全因死亡风险之间存在显著关联。与第二代药物洗脱支架相比，第一代药物洗脱支架的全因死亡率较低。
