Author + information
- Aleksander Zurakowski1,
- Mateusz Kachel1,
- Dariusz Szykowski1,
- Przemek Nowakowski2,
- Krzysztof Milewski1 and
- Piotr Buszman1
Some patients receiving dual antiplatelet therapy after DES implantation require surgery to be performed during DAPT administration period. Patients undergoing major vascular surgery are at high risk of cardiovascular complications. Aim of our research was to assess the risk of premature cessation of DAPT after PCI with second generation DES implantation in this population.
Study group consisted of 79 patients who underwent PCI with second generation DES implantation between 2010 and 2014 and major vascular surgery 30 days to 12 months after PCI, requiring discontinuation of DAPT in perioperative period. We assessed the frequency of death, MI, major bleeding episodes and other adverse events in short and long-term observation.
Time between PCI and DAPT cessation was 105 days on average. We reported no MI, death, or major bleeding in perioperative period after vascular surgery. During the follow up period of mean 2.60(0.17-5.75) years, we recorded 13(16.5%) deaths, of which 7(8.9%) were heart related, 6 MI(7.6%), 5 strokes(6.3%) and 1(1.3%) major bleeding. Kaplan-Meyer estimator showed that time between procedures(<180 vs >180 days) was not a predictor of mortality(p=0.50) and MACCE(p=0.64)(Figure). In a multivariate analysis, the only independent factor of mortality was left ventricular ejection fraction.
In patients with peripheral atherosclerosis requiring major vascular surgery after PCI with second generation DES implantation, early discontinuation of DAPT(>30 days) seems not to be associated with increased risk of death, MI, or major bleeding.
CORONARY: Stents: Drug-Eluting