Current recommendations for delaying noncardiac surgery following stent placement are outdated and lack evidence, according to an article published in the Journal of the American Medical Association.
Guidelines recommend delaying noncardiac surgery one year for patients with drug-eluting stents and six weeks for patients with bare metal stents.
Researchers followed approximately 42,000 noncardiac operations on coronary stent patients between 2000 and 2010 and measured the risk of major adverse cardiac events given cardiac risk factors. They found the following risk factors contribute to risk of MACE after noncardiac surgery:
1. Emergency stent surgery
2. History of heart attack in six months before surgery
3. Revised cardiac risk index greater than two
4. Time between stenting and noncardiac surgery
5. Stent type (DES vs. BMS)
Importantly, time between stenting and surgery was only associated with greater risk for MACE between six weeks and six months post-stenting. Stent type was only a factor in MACE up to six months after stenting.
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