Abstract 3136: Characterization of Mortality Risk Associated with Surgery Following Drug Eluting Stent Use
Introduction: There is mounting evidence of stent thrombosis and associated adverse events following cessation of dual antiplatelet therapy in patients with drug eluting stents (DES). However, the risk of adverse events in relation to surgical procedures following DES remains less well-defined.
Methods: We identified all patients that have had percutaneous coronary intervention (PCI) with DES at Cleveland Clinic since 2003 and had an inpatient surgical procedure at any time point after PCI. Baseline demographic information including antiplatelet therapy status at time of surgery was collected. Social security death index was used to obtain mortality data. The primary endpoint was the risk of all-cause mortality following surgery.
Results: 485 patients underwent PCI with DES followed by index surgical procedure at Cleveland Clinic. The 30-day mortality rates were significantly different depending on time from PCI to surgery. Baseline characteristics based on time to surgery from PCI are shown in the table⇓. A significantly higher proportion of patients going to surgery within one month of PCI were on clopidogrel at least 72 hours prior to surgery.
Conclusion: This is the first description of short-term mortality estimates following surgical procedures after DES. Mortality is significantly increased if surgery has to be performed within 30 days of DES implantation. However, in this cohort there was no difference in mortality after this time period.