ARTICLE
Catastrophic outcomes of noncardiac surgery soon after coronary stenting
Grzegorz L. Ka uza, MD, PhDa,
Jane Josepha,
Joseph R. Lee, MDa,
Michael E. Raizner, MDa and
Albert E. Raizner, MD, FACCa
a Methodist Hospital, Baylor College of Medicine, Houston, Texas, USA
Manuscript received May 11, 1999;
revised manuscript received September 20, 1999,
accepted December 15, 1999.
Reprint requests and correspondence: Dr. Albert E. Raizner, The Methodist Hospital, 6535 Fannin, MS F1034, Houston, Texas 77030
araizner{at}msn.com
 |
Abstract
|
|---|
OBJECTIVES
To assess the clinical course of patients who have undergone coronary stent placement less than six weeks before noncardiac surgery.
BACKGROUND
Surgical and percutaneous transluminal coronary angioplasty revascularization performed before high-risk noncardiac surgery is expected to reduce perioperative cardiac morbidity and mortality. Perioperative and postoperative complications in patients who have undergone coronary stenting before a noncardiac surgery have not been studied.
METHODS
Forty patients who underwent coronary stent placement less than six weeks before noncardiac surgery requiring a general anesthesia were included in the study (1–39 days, average: 13 days). The records were screened for the occurrence of adverse clinical events, including myocardial infarction, stent thrombosis, peri- and postoperative bleeding and death.
RESULTS
In 40 consecutive patients meeting the study criteria, there were seven myocardial infarctions (MIs), 11 major bleeding episodes and eight deaths. All deaths and MIs, as well as 8/11 bleeding episodes, occurred in patients subjected to surgery fewer than 14 days from stenting. Four patients expired after undergoing surgery one day after stenting. Based on electrocardiogram, enzymatic and angiographic evidence, stent thrombosis accounted for most of the fatal events. The time between stenting and surgery appeared to be the main determinant of outcome.
CONCLUSIONS
Postponing elective noncardiac surgery for two to four weeks after coronary stenting should permit completion of the mandatory antiplatelet regimen, thereby reducing the risk of stent thrombosis and bleeding complications.
|
Abbreviations and Acronyms
| | CABG | = coronary artery bypass grafting | | CAD | = coronary artery disease | | CX | = circumflex coronary artery | | ECG | = electrocardiogram | | LAD | = left anterior descending coronary artery | | MI | = myocardial infarction | | OM | = obtuse marginal branch | | PTCA | = percutaneous transluminal coronary angioplasty | | RCA | = right coronary artery |
|
Preoperative identification and treatment of coronary artery disease (CAD) is a commonly accepted practice when referring patients for noncardiac surgery requiring general anesthesia. This practice is felt to reduce perioperative morbidity and mortality (1). Studies indicate that patients with CAD who are revascularized by coronary artery bypass grafting (CABG) before undergoing noncardiac surgery have a reduced incidence of myocardial infarction (MI) and postoperative death (2). The impact of percutaneous transluminal coronary angioplasty (PTCA) procedures on the complications after noncardiac surgery is less explored. Several clinical studies have examined perioperative complications in patients who underwent PTCA before noncardiac surgery and found a low perioperative morbidity (3–6). However, no studies to date have reviewed postoperative outcomes in patients who undergo PTCA and implantation of a coronary stent before a noncardiac surgery.
Therefore, this study attempted to estimate whether similar perioperative benefit exists for patients who undergo PTCA with stent placement before noncardiac surgery.
|
Methods
|
|---|
Between 1996 and the end of 1998 at the Methodist Hospital, Houston, Texas, 40 consecutive patients who underwent coronary stent placement less than six weeks before a noncardiac surgical procedure requiring general anesthesia were identified. The records were reviewed and surgical outcomes were carefully scrutinized for evidence of adverse clinical events such as: stent thrombosis, MI, bleeding complications and death in the perioperative period. Special attention was given to initiation, withdrawal and continuation of each patient’s antiplatelet therapy during the perioperative and postoperative period.
Bleeding complications were more difficult to grade as many of the surgical procedures performed are considered inherently associated with high blood loss. Excessive bleeding was, therefore, defined as the postoperative need for transfusion or bleeding that necessitated reoperation. Unusual blood loss or drainage in the perioperative period was also assessed. Myocardial infarction was diagnosed by characteristic electrocardiogram (ECG) changes or an increase in creatinine kinase levels.
Statistical analysis.
Continuous variables are presented as mean value ± SD. Discrete variables are described as frequencies and percentages and were compared by chi-square and Fisher exact test. P < 0.05 was considered statistically significant.
|
Results
|
|---|
The 40 patients included in this study underwent surgery 1 to 39 days after coronary stent placement (average 13 days). The surgical procedures included: carotid endarterectomy (n = 12), thoracic or abdominal aortic aneurysm resection (n = 9), aortoiliac bypass grafting (n = 2), aortobifemoral of femoral-popliteal bypass grafting (n = 3), arteriovenous shunt placement or revision (n = 2), mitral valve replacement (n = 1), lung transplantation (n = 1), cholecystectomy (n = 2), sigmoid colectomy (n = 1), femoral embolectomy (n = 1), nephrectomy (n = 1), prostatectomy (n = 1), left upper lobectomy of the lung (n = 1), foot amputation (n = 1), parathyroidectomy (n = 1) and cystectomy (n = 1).
All 40 patients received at least one dose of ticlopidine (250–500 mg) immediately after the stenting procedure. All patients were receiving aspirin before stenting. Both antiplatelet drugs were continued after stenting for a variable period of time. Nine patients received abciximab during coronary intervention.
The CAD history, risk profile and procedural details of the studied group are summarized in Table 1.
Eight out of 40 patients expired. Relevant clinical details of the patients who expired are summarized in Table 2. In six patients (A.S., G.W., H.L., W.A., V.G., J.C.), death was related to MI. In two other patients (R.C., J.H.), death was associated with a bleeding complication. Four patients (G.W., H.L., W.A., J.C.) had both MI and bleeding complications ultimately leading to death. Seven patients suffered MIs, of which six were fatal and one (F.D.) was minimized due to successful emergent PTCA. Of these seven patients, two had single vessel disease, three had double vessel disease and two had triple vessel disease. All critically stenosed vessels were successfully stented. In three patients (A.S., G.W., V.G.) the residual diseased vessels had lesions of borderline severity (50%) and were not associated with demonstrable ischemia. In two patients (F.D., W.A.), the untreated vessels were right coronary arteries (RCAs), which were chronically occluded and well-collateralized.
View this table:
[in this window]
[in a new window]
|
Table 2 A Summary of Time Frames of PTCA, Surgery, Antiplatelet Therapy and Complications in Patients Who Experienced Major Complications After Noncardiac Surgery Preceded by Intracoronary Stent Placement
|
|
Stent thrombosis was presumed to be the cause of all of the MIs; in two patients (F.D., J.C.), stent thrombosis was confirmed angiographically. In four others, ECG changes of infarction or ischemia were in the areas subtended by the stented artery. One patient (G.W.) who experienced chest pain and sudden death at home had triple vessel disease with two severe stenoses (left anterior descending coronary artery [LAD] and RCA), which were treated with multiple stents.
All deaths and MIs as well as 8 of 11 bleeding episodes occurred in patients who underwent surgery in less than two weeks after coronary stent placement. The incidence of death and MI was significantly higher in this subset than it was in patients subjected to surgery more than 14 days after stenting (p = 0.015 by Fisher exact test). As such, the mortality rate among 25 patients operated within this two-week timeframe was 32%. Of five patients who underwent surgery one day after stenting, four expired (bleeding was involved in three patients). The fifth patient underwent surgery the day after stent placement, had no discontinuation of either antiplatelet drug and experienced no adverse event. One patient (F.D.), who was subjected to surgery two days after stenting, experienced stent thrombosis with cardiac arrest. He was successfully treated with an emergency PTCA but required hospitalization for more than seven weeks.
Five patients had no discontinuation of ticlopidine before surgery. Three of these patients (G.W., R.C., W.A.) underwent surgery less than three days from stenting, and each expired. One (G.W.) required reoperation twice for hematoma. Ticlopidine was then stopped. He died suddenly four days later at home while experiencing severe chest pain and was presumed to have an MI. Another patient (R.C.) required reoperation for hemothorax and needed 11 units of blood transfused. He died of deteriorating heart failure on postoperative day 3. A third patient, (W.A.) required reoperation 4 h after surgery for bleeding. Four hours later he developed an acute inferior MI with recurrent ventricular tachycardia and died seven days later. Two other patients underwent surgery one day and five days after stenting, respectively, and both made uneventful recoveries.
Of eight deceased patients, one had no discontinuation of either antiplatelet drug, two patients had ticlopidine withdrawn and aspirin continued, and six patients had both drugs stopped 0 to 2 days before going to surgery (zero denoting the day of surgery).
In the remaining 32 patients, most had both antiplatelet drugs discontinued 0 to 1 day before and restarted 0 to 1 day after surgery.
Patients who underwent surgery less than two weeks after coronary stenting (n = 25) were subjected to similar types of surgical procedures as those undergoing surgery between two and six weeks (n = 15). The percent of patients receiving abciximab during the stent placement was also similar in both subgroups (5/25 vs. 4/15). The following case histories provide insight into the dynamics of these events.
|
Case reports
|
|---|
Case 1 (1996).
A 67-year-old man with a history of CAD treated with PTCA and COPD was evaluated before resection of an infrarenal aortic aneurysm. A 90% restenosis lesion in the midportion of the circumflex artery was successfully treated with PTCA and a 3.0-mm Palmaz-Schatz stent (Fig. 1, A and B). Ticlopidine was started the day of PTCA and was stopped one day later. Aspirin, continued from before the procedure, was stopped two days after stenting, i.e., the day the patient underwent aneurysmectomy.
View larger version (72K):
[in this window]
[in a new window]
|
Figure 1 Patient F.D., case history #1. (A) 70% eccentric stenosis of the circumflex coronary artery. (B) After successful placement of 3.0 Palmaz-Schatz coronary stent. (C) Total occlusion due to stent thrombosis on the sixth day after surgery.
|
|
Six days after surgery, the patient became hypotensive. His ECG at that time revealed 2 to 3 mm ST segment depression in leads V3 to V6. An episode of ventricular fibrillation followed the hypotension, and the patient was successfully defibrillated. The patient underwent emergent cardiac catheterization that revealed 100% occlusion of the circumflex artery in the previously stented segment (Fig. 1C). The occluded artery was successfully opened by PTCA. The ECG changes resolved after PTCA, and there was no subsequent formation of Q waves. Creatine kinase MB levels were not obtained. Ticlopidine was restarted and continued for four weeks from stenting. The patient survived; however, his hospitalization was prolonged to over seven weeks because of slow weaning from the mechanical ventilator.
Case 2 (1997).
A 62-year-old woman with interstitial pulmonary fibrosis was evaluated for lung transplantation. Cardiac catheterization revealed an 80% stenosis of the proximal circumflex artery. The patient underwent PTCA resulting in a nonocclusive dissection, which was successfully treated with a 3.0-mm Palmaz-Schatz stent (Fig. 2, A and B). Ticlopidine was started on the day of the PTCA. Aspirin, continued from before the procedure, was stopped together with ticlopidine five days after stenting, i.e., the day the patient underwent single lung transplant.
View larger version (74K):
[in this window]
[in a new window]
|
Figure 2 Patient J.C., case history #2. (A) Initial angiographic appearance of the lesion in the circumflex coronary artery. (B) Postprocedural result with 3.0 Palmaz-Schatz stent. (C) Total thrombotic occlusion of the previously stented site on the first postoperative day, not amenable to angioplasty.
|
|
Twenty-four hours after transplantation, the patient developed respiratory distress, hypotension and 2 to 3 mm ST segment elevation in ECG leads V3 to V6. Emergency coronary angiography revealed 100% occlusion of the stent (Fig. 2C). All attempts to cross this occlusion with a guidewire were unsuccessful. An intraaortic balloon pump was placed. New Q waves were subsequently noted on the ECG. Ticlopidine and aspirin were restarted one day later. On the sixth postoperative day, the patient suffered a hemorrhagic cerebrovascular accident. She was declared brain dead and expired on postoperative day 11. An autopsy revealed a recent lateral wall MI. The stent site was patent.
Case 3 (1998).
A 72-year-old woman with known CAD was admitted for work-up of chronic iron deficiency anemia. On cardiac catheterization, a 95% lesion in mid-LAD was revealed and treated with a 3.5-mm Crown stent. Three days later the colonoscopy disclosed an infiltrating, partially obstructing sigmoid adenocarcinoma. Thus, she was subjected to sigmoid colectomy five days after coronary stenting. Ticlopidine and aspirin were discontinued on the day of surgery. Two hours after surgery, she developed bradycardia and severe ECG changes consistent with an acute anterior MI (Fig. 3) and pulmonary edema requiring reintubation. Two days later, in the intensive care unit, she extubated herself, went into respiratory arrest and could not be resuscitated.
View larger version (79K):
[in this window]
[in a new window]
|
Figure 3 Patient V.G., case history #3. Electrocardiogram recorded during chest pain and symptoms of pulmonary edema. Bradycardia and ST segment changes consistent with myocardial infarction.
|
|
|
Discussion
|
|---|
This study reveals an extraordinarily high incidence of catastrophic perioperative complications in patients who undergo elective or semielective noncardiac surgery soon after implantation of a coronary stent. These complications include acute MI and death, which appear to be directly or indirectly related to the preceding coronary intervention because all the ischemic manifestations occurred in the distribution of the stented arteries.
Through their use in interventional cardiology, intracoronary stents have dramatically improved the outcome of percutaneous coronary intervention by reducing the need for emergent bypass surgery, improving immediate angiographic results and reducing the rate of subsequent restenosis. Consequently, they are now used in more than 50% of all PTCA procedures (7) and up to 90% in some hospitals. Some of these procedures are performed for the purpose of treating critical coronary lesions in patients who will subsequently undergo elective or semielective surgery. Treating these lesions before surgery is expected to reduce the incidence of perioperative and postoperative complications.
When first introduced, stents were plagued by a high rate of acute or subacute thrombosis, which was generally attended by acute MI (8). However, current technical advances, such as high pressure balloon deployment (9) and more effective antiplatelet regimens, have reduced the rate of thrombosis to less than 1%. This low rate of thrombotic closure is supported by recent clinical trial data (10–13).
The Fifth American College of Chest Physicians Consensus on Antithrombotic Therapy has recently formulated recommendations for antiplatelet therapy after coronary stent placement. Patients who are at high risk for stent thrombosis should be given ticlopidine for 30 days, and all other patients should receive ticlopidine for at least 14 days (14). It is also known that the use of aspirin without ticlopidine results in a five times greater incidence of stent thrombosis (12). Ticlopidine reaches peak antiplatelet effect in approximately three to five days from initiation (15), and patients who are treated with ticlopidine for several days before stent placement have a significantly lower incidence of procedural non-Q wave MI than those who begin ticlopidine the day of the procedure (16).
In the group of patients reported herein, the most catastrophic adverse event appeared to be stent thrombosis, which usually leads to MI and death. In two patients, stent thrombosis was documented angiographically. In five others, stent thrombosis was presumed to be responsible since the MI occurred in the territory supplied by the stented artery. In this group of patients, one or both antiplatelet drugs were typically interrupted one to two days before surgery, which would be the general practice in patients about to undergo surgery. The impact of abrupt withdrawal or interruption from this antithrombotic regimen seems to account for the unacceptable rate of acute coronary thrombosis.
Of note, all of the major adverse events occurred in patients who underwent surgery within 14 days of stent implantation. The interruption or withdrawal of the antiplatelet regimen in this two-week window coincidentally corresponds with the time frame during which stent thrombosis would likely occur and would appear to explain the high incidence of stent thrombosis. Of the total seven MIs, four occurred within 24 h of the surgical procedure, while the other three developed at 6, 7 and 11 days after procedure. Overall, 8 of the 25 patients who underwent surgery within 14 days of stent placement expired within 11 days of the surgical procedure after suffering an MI or significant bleeding episode.
Bleeding complications were unusually high and were often combined with stent thrombosis. Aspirin (17) and ticlopidine (18,19), used to prevent stent thrombosis, are known to increase the risk of bleeding when administered before a surgical procedure. Some of the patients had no discontinuation of either medication after stent placement, placing them at an even higher risk for bleeding. The pharmacodynamics of both drugs make stopping either drug 1 to 2 days before surgery ineffective in diminishing the risk of bleeding.
Thus, stent implantation before surgery appears to be a double-edge sword. If antiplatelet drugs are withheld, the likelihood of stent thrombosis is greatly enhanced. If antiplatelet therapy is continued, the risk of postoperative bleeding is increased. Since neither of these alternatives is acceptable, elective surgery should be delayed for at least two weeks after coronary stent implantation.
Some of the patients included in this study did undergo noncardiac surgery early after stenting but did not have a major cardiac complication. Five of these patients, however, did experience excessive, but not catastrophic, bleeding complications.
The relationship between performing elective noncardiac surgery shortly after coronary stenting and the serious adverse consequences of such action has been overlooked. From the perspective of individual physicians, these disastrous events may have been perceived as single-case complications. Yet, when data from a high volume angioplasty and surgery center is revealed, the results are alarming.
In contrast to the alarming results of this study, when PTCA was performed before, or in preparation for noncardiac surgery, earlier studies have demonstrated a reduction of perioperative cardiac complications (3–6). While patients who undergo PTCA without stent placement are benefited by antiplatelet therapy, they are less prone to thrombosis than patients who do have stents implanted since aspirin alone is protective (14). The discontinuation of antiplatelet therapy in the perioperative period does not appear to be attended by the same thrombotic catastrophe that we observed in stented patients. Hence, when a coronary intervention is performed in a patient who is being considered for surgery soon after coronary intervention, efforts should be made to avoid stent placement if possible.
This review provides guidelines for the care of a patient who undergoes stent implantation and proceeds to elective noncardiac surgery. Based on those observations, cardiologists and surgeons should refrain from performing noncardiac elective operations within 14 days of coronary stenting, when interruption of the poststent antiplatelet treatment appears to directly contribute to adverse and often fatal events after surgery. In patients whose surgery is semielective or emergent, the decision to proceed with or to delay surgery should be made with full weighing of the relative risks inherent in either choice.
Study limitations.
It may be argued that this study represents a retrospective observational analysis performed in a cohort that is very heterogeneous in terms of the variety of stents used, the different complexities of the interventional and surgical procedures and the variety of operators. However, we believe that the uniformity of the outcome (unfavorable) despite the heterogeneity of the cohort bespeaks a strong message and obviates the need for a randomized trial.
Conclusions.
We postulate that elective noncardiac surgery should be postponed for several weeks after coronary stenting, allowing the completion of currently recommended 2 to 4 weeks of antiplatelet therapy. This would be expected to keep the acute and subacute stent thrombosis rates equal to the general population of patients undergoing coronary stenting. Additionally, for the limitation of perioperative bleeding, it would be ideal to wait several further days for aspirin and ticlopidine to stop exerting their effects.
It should be also borne in mind that optimal "stent-like" results can be obtained by conventional balloon PTCA with ultrasound guidance (20,21) and may be a substitute for elective coronary stenting. This alternative might be ideal for CAD patients awaiting later noncardiac surgery because such an approach would at least exclude the potential hazards of aggressive two-drug antiplatelet therapy obligatory after stenting. A recent study showed that optimal balloon angioplasty with provisional stenting (used for bail-out or early loss after 30 min only) is equivalent to primary stenting in event-free survival, target vessel revascularization and restenosis at six months (22). Although not universally accepted for patients undergoing percutaneous revascularization, such approaches are at least proven feasible and safe and, thus, may supersede stenting in the specific cohort of CAD patients undergoing PTCA as a result of cardiac work-up before elective noncardiac surgery.
|
Acknowledgments
|
|---|
The authors gratefully acknowledge the secretarial and editorial assistance of Ms. Dee-Dee Webb.
|
Footnotes
|
|---|
This study was financed by the Cardiac Cath Lab Research Center, the Methodist Hospital Research Foundation, Houston, Texas.
|
References
|
|---|
1. Eagle KA, Brundage BH, Chaitman BR, et al. ACC/AHA Task Force Special Report: guidelines for perioperative cardiovascular evaluation for noncardiac surgery. Circulation. 1996;93:1278–1317[Medline]
2. CASS Investigators and University of Michigan Heart Care ProgramEagle KA, Rihal CS, Mickel MC, et al. Cardiac risk of noncardiac surgery. Influence of coronary disease and type of surgery in 3,368 operations. Circulation. 1997;96:1882–1887[Abstract/Free Full Text]
3. Allen JR, Helling TS, Hartzler GO. Operative procedures not involving the heart after percutaneous transluminal coronary angioplasty. Surg Gynecol Obstet. 1991;173:285–288[Medline]
4. Huber KC, Evans MA, Breshanan JF, Gibbons RJ, Holmes DR Jr. Outcome of noncardiac operations in patients with severe coronary artery disease successfully treated preoperatively with coronary angioplasty. Mayo Clin Proc. 1992;67:15–21[Medline]
5. Elmore JR, Halett JW Jr, Gibbons RJ, et al. Myocardial revascularization before abdominal aortic aneurysmorrhaphy: effect of coronary angioplasty. Mayo Clin Proc. 1993;68:637–641[Medline]
6. Gottlieb A, Banoub M, Sprung J, et al. Perioperative cardiovascular morbidity in patients with coronary artery disease undergoing vascular surgery after percutaneous transluminal coronary angioplasty. J Cardiothorac Vasc Anest. 1998;12:501–506[CrossRef][Medline]
7. Topol EJ, Serruys PW. Frontiers in interventional cardiology. Circulation. 1998;98:1802–1820[Free Full Text]
8. Hasdai D, Garratt KN, Holmes DR, Berge PB, Schwartz RS, Bell MR. Coronary angioplasty and intracoronary thrombolysis are of limited efficacy in resolving early intracoronary stent thrombosis. J Am Coll Cardiol. 1996;28:361–367[Abstract]
9. Colombo A, Hall P, Nakamura S, et al. Intracoronary stenting without anticoagulation accomplished with intravascular ultrasound guidance. Circulation. 1995;91:1676–1688[Abstract/Free Full Text]
10. Schömig A, Neumann FJ, Kastrati A, et al. A randomized comparison of antiplatelet and anticoagulant therapy after the placement of coronary artery stents. N Engl J Med. 1996;334:1084–1089[CrossRef][Medline]
11. Bertrand ME, Legrand V, Boland J, et al. Randomized multicenter comparison of conventional anticoagulation versus antiplatelet therapy in unplanned and elective coronary stenting. The full anticoagulation versus aspirin and ticlopidine (fantastic) study. Circulation. 1998;98:1597–1603[Abstract/Free Full Text]
12. Stent Anticoagulation Restenosis Study InvestigatorsLeon MB, Baim DS, Popma JJ, et al. A clinical trial comparing three antithrombotic-drug regimens after coronary artery stenting. N Engl J Med. 1998;339:1665–1671[CrossRef][Medline]
13. MATTIS InvestigatorsUrban P, Macaya C, Rupprecht H-J, et al. Randomized evaluation of anticoagulation versus antiplatelet therapy after coronary stent implantation in high-risk patients. The Multicenter Aspirin and Ticlopidine Trial After Coronary Stenting (MATTIS). Circulation. 1998;98:2126–2132[Abstract/Free Full Text]
14. Popma JJ, Weitz J, Bittl JA, et al. Antithrombotic therapy in patients undergoing coronary angioplasty. Chest. 1998;114:728S–741S[Free Full Text]
15. Schror K. Antiplatelet drugs. A comparative review. Drugs. 1995;50:1–28[Medline]
16. Steinhubl SR, Lauer MS, Mukherjee DP, et al. The duration of pretreatment with ticlopidine prior to stenting is associated with the risk of procedure-related non-Q wave myocardial infarctions. J Am Coll Cardiol. 1998;32:1366–1370[Abstract/Free Full Text]
17. Ferraris VA, Ferraris S. Update on "Perioperative aspirin ingestion increases operative blood loss after coronary artery bypass grafting" published in 1988. Ann Thorac Surg. 1995;59:1036–1037[Abstract/Free Full Text]
18. Criado A, Juffe A, Carmona J. Ticlopidine as a hemorrhagic risk factor in coronary surgery. Drug Intell Clin Pharm. 1985;19:673–676[Abstract]
19. Caliendo G, Bradbury K, Mehl B. Ticlopidine, bleeding and surgery. Mt Sinai J Med. 1994;61:372–373[Medline]
20. Stone GW, Hodgson JMcB, St. Goar FG, et al. Improved procedural results of coronary angioplasty with intravascular ultrasound-guided balloon sizing: the CLOUT Pilot Trial. Clinical Outcomes With Ultrasound Trial (CLOUT) Investigators. Circulation. 1997;95:2044–2052[Abstract/Free Full Text]
21. Haase KK, Athanasiadis A, Mahrholdt H, et al. Acute and one year follow-up results after vessel size adapted PTCA using intracoronary ultrasound. Eur Heart J. 1998;9:63–272
22. OCBAS InvestigatorsRodriguez A, Ayala F, Bernardi V, et al. Optimal coronary balloon angioplasty with provisional stenting versus primary stent (OCBAS). J Am Coll Cardiol. 1998;32:1351–1357[Abstract/Free Full Text]
This article has been cited by other articles:
|
|
|
|
 
J. D. Douketis, A. C. Spyropoulos, F. A. Spencer, M. Mayr, A. K. Jaffer, M. H. Eckman, A. S. Dunn, and R. Kunz
Perioperative Management of Antithrombotic Therapy: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines
Chest,
February 1, 2012;
141(2_suppl):
e326S - e350S.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. A. Gorin, J. Gahan, E. Antebi, R. I. Carey, and V. G. Bird
Laparoscopic-Guided Radiofrequency Ablation is Safe for the Treatment of Enhancing Renal Masses Among Patients Prescribed Antithrombotic Agents
Clinical and Applied Thrombosis/Hemostasis,
January 1, 2012;
18(1):
35 - 39.
[Abstract]
[PDF]
|
|
|
|
|
|
|
G. N. Levine, E. R. Bates, J. C. Blankenship, S. R. Bailey, J. A. Bittl, B. Cercek, C. E. Chambers, S. G. Ellis, R. A. Guyton, S. M. Hollenberg, et al.
2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions
J. Am. Coll. Cardiol.,
December 6, 2011;
58(24):
e44 - e122.
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. N. Levine, E. R. Bates, J. C. Blankenship, S. R. Bailey, J. A. Bittl, B. Cercek, C. E. Chambers, S. G. Ellis, R. A. Guyton, S. M. Hollenberg, et al.
2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention: Executive Summary: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions
J. Am. Coll. Cardiol.,
December 6, 2011;
58(24):
2550 - 2583.
[Full Text]
[PDF]
|
|
|
|
|
|
|
Writing Committee Members, G. N. Levine, E. R. Bates, J. C. Blankenship, S. R. Bailey, J. A. Bittl, B. Cercek, C. E. Chambers, S. G. Ellis, R. A. Guyton, et al.
2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions
Circulation,
December 6, 2011;
124(23):
e574 - e651.
[Full Text]
[PDF]
|
|
|
|
|
|
|
Writing Committee Members, G. N. Levine, E. R. Bates, J. C. Blankenship, S. R. Bailey, J. A. Bittl, B. Cercek, C. E. Chambers, S. G. Ellis, R. A. Guyton, et al.
2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention: Executive Summary: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions
Circulation,
December 6, 2011;
124(23):
2574 - 2609.
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. P. Ceppa, I. J. Welsby, T. Y. Wang, M. W. Onaitis, B. C. Tong, D. H. Harpole, T. A. D'Amico, and M. F. Berry
Perioperative Management of Patients on Clopidogrel (Plavix) Undergoing Major Lung Resection
Ann. Thorac. Surg.,
December 1, 2011;
92(6):
1971 - 1976.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. A. Gaglia Jr and R. Waksman
Systematic review of thienopyridine discontinuation and its impact upon clinical outcomes
Eur. Heart J.,
October 1, 2011;
32(19):
2358 - 2364.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. Albaladejo, E. Marret, C.-M. Samama, J.-P. Collet, K. Abhay, O. Loutrel, H. Charbonneau, S. Jaber, S. Thoret, J.-L. Bosson, et al.
Non-cardiac surgery in patients with coronary stents: the RECO study
Heart,
October 1, 2011;
97(19):
1566 - 1572.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. Suzuki, A. Usui, K. Yoshida, A. Matsuura, T. Ichihara, and Y. Ueda
Effect of Cardiopulmonary Bypass on Cancer Prognosis
Asian Cardiovasc Thorac Ann,
December 1, 2010;
18(6):
536 - 540.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T.-H. Chen and R. Matyal
The Management of Antiplatelet Therapy in Patients With Coronary Stents Undergoing Noncardiac Surgery
Seminars in Cardiothoracic and Vascular Anesthesia,
December 1, 2010;
14(4):
256 - 273.
[Abstract]
[PDF]
|
|
|
|
|
|
|
P. Barash and S. Akhtar
Coronary stents: factors contributing to perioperative major adverse cardiovascular events
Br. J. Anaesth.,
December 1, 2010;
105(suppl_1):
i3 - i15.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. J. Cerfolio, D. J. Minnich, and A. S. Bryant
General thoracic surgery is safe in patients taking clopidogrel (Plavix)
J. Thorac. Cardiovasc. Surg.,
November 1, 2010;
140(5):
970 - 976.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. B. Berger, N. S. Kleiman, M. J. Pencina, W.-H. Hsieh, S. R. Steinhubl, A. Jeremias, A. Sonel, K. Browne, G. Barseness, D. J. Cohen, et al.
Frequency of Major Noncardiac Surgery and Subsequent Adverse Events in the Year After Drug-Eluting Stent Placement: Results From the EVENT (Evaluation of Drug-Eluting Stents and Ischemic Events) Registry
J. Am. Coll. Cardiol. Intv.,
September 1, 2010;
3(9):
920 - 927.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. F. Dineen, R. J. Curtin, and J. A. Harty
A review of the use of common antiplatelet agents in orthopaedic practice
J Bone Joint Surg Br,
September 1, 2010;
92-B(9):
1186 - 1191.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. Smout and R. Naylor
Vascular surgery: operating on patients on clopidogrel or warfarin
Clin Risk,
July 1, 2010;
16(4):
135 - 140.
[Full Text]
[PDF]
|
|
|
|
|
|
|
H. Mollmann, H. M. Nef, and C. W. Hamm
Antiplatelet therapy during surgery
Heart,
June 1, 2010;
96(12):
986 - 991.
[Full Text]
[PDF]
|
|
|
|
|
|
|
N. L. M. Cruden, S. A. Harding, A. D. Flapan, C. Graham, S. H. Wild, R. Slack, J. P. Pell, D. E. Newby, and on behalf of the Scottish Coronary Revascularisati
Previous Coronary Stent Implantation and Cardiac Events in Patients Undergoing Noncardiac Surgery
Circ Cardiovasc Interv,
June 1, 2010;
3(3):
236 - 242.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. C. Decker, J. R. Foley, and T. J. Moore
Perioperative Management of the Patient With Cardiac Disease
J. Am. Acad. Orthop. Surg.,
May 1, 2010;
18(5):
267 - 277.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. Fiorella
Anti-thrombotic medications for the neurointerventionist: aspirin and clopidogrel.
JNIS,
March 1, 2010;
2(1):
44 - 49.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. Savonitto, M. D'Urbano, M. Caracciolo, F. Barlocco, G. Mariani, M. Nichelatti, S. Klugmann, and S. De Servi
Urgent surgery in patients with a recently implanted coronary drug-eluting stent: a phase II study of 'bridging' antiplatelet therapy with tirofiban during temporary withdrawal of clopidogrel
Br. J. Anaesth.,
March 1, 2010;
104(3):
285 - 291.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Oscarsson, A. Gupta, M. Fredrikson, J. Jarhult, M. Nystrom, E. Pettersson, B. Darvish, H. Krook, E. Swahn, and C. Eintrei
To continue or discontinue aspirin in the perioperative period: a randomized, controlled clinical trial
Br. J. Anaesth.,
March 1, 2010;
104(3):
305 - 312.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. O. Abualsaud and M. J. Eisenberg
Perioperative Management of Patients With Drug-Eluting Stents
J. Am. Coll. Cardiol. Intv.,
February 1, 2010;
3(2):
131 - 142.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. C. Becker, J. Scheiman, H. L. Dauerman, F. Spencer, S. Rao, M. Sabatine, D. A. Johnson, F. Chan, N. S. Abraham, E. M.M. Quigley, et al.
Management of Platelet-Directed Pharmacotherapy in Patients With Atherosclerotic Coronary Artery Disease Undergoing Elective Endoscopic Gastrointestinal Procedures
J. Am. Coll. Cardiol.,
December 8, 2009;
54(24):
2261 - 2276.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
American College of Cardiology Foundation, American Heart Association Task Force on Practice, American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Rhythm Society, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interve, Society for Vascular Medicine, Society for Vascular Surgery, L. A. Fleisher, et al.
2009 ACCF/AHA Focused Update on Perioperative Beta Blockade Incorporated Into the ACC/AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery
J. Am. Coll. Cardiol.,
November 24, 2009;
54(22):
e13 - e118.
[Full Text]
[PDF]
|
|
|
|
|
|
|
2007 WRITING COMMITTEE MEMBERS, L. A. Fleisher, J. A. Beckman, K. A. Brown, H. Calkins, E. L. Chaikof, K. E. Fleischmann, W. K. Freeman, J. B. Froehlich, E. K. Kasper, et al.
2009 ACCF/AHA Focused Update on Perioperative Beta Blockade Incorporated Into the ACC/AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines
Circulation,
November 24, 2009;
120(21):
e169 - e276.
[Full Text]
[PDF]
|
|
|
|
|
|
|
Authors/Task Force Members, D. Poldermans, J. J. Bax, E. Boersma, S. De Hert, E. Eeckhout, G. Fowkes, B. Gorenek, M. G. Hennerici, B. Iung, et al.
Guidelines for pre-operative cardiac risk assessment and perioperative cardiac management in non-cardiac surgery: The Task Force for Preoperative Cardiac Risk Assessment and Perioperative Cardiac Management in Non-cardiac Surgery of the European Society of Cardiology (ESC) and endorsed by the European Society of Anaesthesiology (ESA)
Eur. Heart J.,
November 2, 2009;
30(22):
2769 - 2812.
[Full Text]
[PDF]
|
|
|
|
|
|
|
M Luckie, R S Khattar, and D Fraser
Non-cardiac surgery and antiplatelet therapy following coronary artery stenting
Heart,
August 15, 2009;
95(16):
1303 - 1308.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. Landesberg, W. S. Beattie, M. Mosseri, A. S. Jaffe, and J. S. Alpert
Perioperative Myocardial Infarction
Circulation,
June 9, 2009;
119(22):
2936 - 2944.
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. J. Napenas, C. H.L. Hong, M. T. Brennan, S. L. Furney, P. C. Fox, and P. B. Lockhart
The Frequency of Bleeding Complications After Invasive Dental Treatment in Patients Receiving Single and Dual Antiplatelet Therapy
J Am Dent Assoc,
June 1, 2009;
140(6):
690 - 695.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. Anwaruddin, A. T. Askari, H. Saudye, L. Batizy, P. L. Houghtaling, M. Alamoudi, M. Militello, K. Muhammad, S. Kapadia, and S. G. Ellis
Characterization of Post-Operative Risk Associated With Prior Drug-Eluting Stent Use
J. Am. Coll. Cardiol. Intv.,
June 1, 2009;
2(6):
542 - 549.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. C.Y. To, G. Armstrong, I. Zeng, and M. W.I. Webster
Noncardiac Surgery and Bleeding After Percutaneous Coronary Intervention
Circ Cardiovasc Interv,
June 1, 2009;
2(3):
213 - 221.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. Smout and G. Stansby
Surgery and antiplatelet agents: what are the risks?
Clin Risk,
May 1, 2009;
15(3):
101 - 105.
[Full Text]
[PDF]
|
|
|
|
|
|
|
M Cleanthis and M. Flather
The dangers of stopping clopidogrel perioperatively: a cardiologist's perspective
Clin Risk,
May 1, 2009;
15(3):
106 - 108.
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. M. O'Riordan, R. J. Margey, G. Blake, and P. R. O'Connell
Antiplatelet Agents in the Perioperative Period
Arch Surg,
January 1, 2009;
144(1):
69 - 76.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. Hoeks and D. Poldermans
CHAPTER 34 Non-cardiac Surgery in Cardiac Patients
ESC Textbook of Cardiovascular Medicine,
January 1, 2009;
2(1):
med-9780199566990-chapter - med-9780199566990-chapter.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
W. Dyszkiewicz, M. Jemielity, C. Piwkowski, M. Kasprzyk, B. Perek, L. Gasiorowski, and E. Kaczmarek
The early and late results of combined off-pump coronary artery bypass grafting and pulmonary resection in patients with concomitant lung cancer and unstable coronary heart disease
Eur J Cardiothorac Surg,
September 1, 2008;
34(3):
531 - 535.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
Current Guidelines for Preoperative Management Leave Me Wanting More
Journal Watch Hospital Medicine,
August 25, 2008;
2008(825):
1 - 1.
[Full Text]
|
|
|
|
|
|
|
L. T. Newsome, R. S. Weller, J. C. Gerancher, M. A. Kutcher, and R. L. Royster
Coronary Artery Stents: II. Perioperative Considerations and Management
Anesth. Analg.,
August 1, 2008;
107(2):
570 - 590.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. Dunning, M. Versteegh, A. Fabbri, A. Pavie, P. Kolh, U. Lockowandt, S. A. M. Nashef, and on behalf of the EACTS Audit and Guidelines Commit
Guideline on antiplatelet and anticoagulation management in cardiac surgery
Eur J Cardiothorac Surg,
July 1, 2008;
34(1):
73 - 92.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. S. Brett
Coronary Assessment Before Noncardiac Surgery: Current Strategies Are Flawed
Circulation,
June 17, 2008;
117(24):
3145 - 3151.
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. Foley, S. Foley, T. Kinnaird, and R.A. Anderson
Clinical review: gastrointestinal bleeding after percutaneous coronary intervention: a deadly combination
QJM,
June 1, 2008;
101(6):
425 - 433.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. D. Douketis, P. B. Berger, A. S. Dunn, A. K. Jaffer, A. C. Spyropoulos, R. C. Becker, and J. Ansell
The Perioperative Management of Antithrombotic Therapy: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition)
Chest,
June 1, 2008;
133(6_suppl):
299S - 339S.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. Godet, Y. Le Manach, F. Lesache, S. Perbet, and P. Coriat
Drug-eluting stent thrombosis in patients undergoing non-cardiac surgery: is it always a problem?
Br. J. Anaesth.,
April 1, 2008;
100(4):
472 - 477.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. D. Kertai
Preoperative Coronary Revascularization in High-Risk Patients Undergoing Vascular Surgery: A Core Review
Anesth. Analg.,
March 1, 2008;
106(3):
751 - 758.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. Landesberg and M. Mosseri
PRO: Preoperative Coronary Revascularization in High-Risk Patients Undergoing Vascular Surgery
Anesth. Analg.,
March 1, 2008;
106(3):
759 - 763.
[Full Text]
[PDF]
|
|
|
|
|
|
|
E. O. McFalls, H. B. Ward, T. E. Moritz, F. S. Apple, S. Goldman, G. Pierpont, G. C. Larsen, B. Hattler, K. Shunk, F. Littooy, et al.
Predictors and outcomes of a perioperative myocardial infarction following elective vascular surgery in patients with documented coronary artery disease: results of the CARP trial
Eur. Heart J.,
February 1, 2008;
29(3):
394 - 401.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
American College of Cardiology/American Heart Asso, 2007 Writing Group to Review New Evidence and Upda, S. B. King III, S. C. Smith Jr, J. W. Hirshfeld Jr, A. K. Jacobs, D. A. Morrison, and D. O. Williams
2007 Focused Update of the ACC/AHA/SCAI 2005 Guideline Update for Percutaneous Coronary Intervention
J. Am. Coll. Cardiol.,
January 15, 2008;
51(2):
172 - 209.
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. B. King III, S. C. Smith Jr, J. W. Hirshfeld Jr, A. K. Jacobs, D. A. Morrison, D. O. Williams, 2005 WRITING COMMITTEE MEMBERS, S. C. Smith Jr, T. E. Feldman, J. W. Hirshfeld Jr, et al.
2007 Focused Update of the ACC/AHA/SCAI 2005 Guideline Update for Percutaneous Coronary Intervention: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines: 2007 Writing Group to Review New Evidence and Update the ACC/AHA/SCAI 2005 Guideline Update for Percutaneous Coronary Intervention, Writing on Behalf of the 2005 Writing Committee
Circulation,
January 15, 2008;
117(2):
261 - 295.
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. E. Bertrand
When and how to discontinue antiplatelet therapy
Eur. Heart J. Suppl.,
January 1, 2008;
10(suppl_A):
A35 - A41.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
L. A. Fleisher, J. A. Beckman, K. A. Brown, H. Calkins, E. L. Chaikof, K. E. Fleischmann, W. K. Freeman, J. B. Froehlich, E. K. Kasper, J. R. Kersten, et al.
ACC/AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery) Developed in Collaboration With the American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Rhythm Society, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, and Society for Vascular Surgery
J. Am. Coll. Cardiol.,
October 23, 2007;
50(17):
e159 - e242.
[Full Text]
[PDF]
|
|
|
|
|
|
|
L. A. Fleisher, J. A. Beckman, K. A. Brown, H. Calkins, E. L. Chaikof, K. E. Fleischmann, W. K. Freeman, J. B. Froehlich, E. K. Kasper, J. R. Kersten, et al.
ACC/AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery)
Circulation,
October 23, 2007;
116(17):
e418 - e500.
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. W. Riddell, L. Chiche, B. Plaud, and M. Hamon
Coronary Stents and Noncardiac Surgery
Circulation,
October 16, 2007;
116(16):
e378 - e382.
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. G. Steg
Revascularization Before Noncardiac Surgery: Is There an Impact of Drug-Eluting Stent Thrombosis?
J. Am. Coll. Cardiol.,
October 2, 2007;
50(14):
1398 - 1398.
[Full Text]
[PDF]
|
|
|
|
|
|
|
P.-G. Chassot, A. Delabays, and D. R. Spahn
Perioperative antiplatelet therapy: the case for continuing therapy in patients at risk of myocardial infarction
Br. J. Anaesth.,
September 1, 2007;
99(3):
316 - 328.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. L. Cohn and G. W. Smetana
Update in Perioperative Medicine
Ann Intern Med,
August 21, 2007;
147(4):
263 - 270.
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. C.J. Schoenmakers, W.-J. van Boven, J. van den Bosch, and H. A. van Swieten
Comparison of On-Pump or Off-Pump Coronary Artery Revascularization With Lung Resection
Ann. Thorac. Surg.,
August 1, 2007;
84(2):
504 - 509.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Thielmann, M. Neuhauser, S. Knipp, E. Kottenberg-Assenmacher, A. Marr, N. Pizanis, M. Hartmann, M. Kamler, P. Massoudy, and H. Jakob
Prognostic impact of previous percutaneous coronary intervention in patients with diabetes mellitus and triple-vessel disease undergoing coronary artery bypass surgery
J. Thorac. Cardiovasc. Surg.,
August 1, 2007;
134(2):
470 - 476.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
Authors/Task Force Members, J.-P. Bassand, C. W. Hamm, D. Ardissino, E. Boersma, A. Budaj, F. Fernandez-Aviles, K. A.A. Fox, D. Hasdai, E. M. Ohman, et al.
Guidelines for the diagnosis and treatment of non-ST-segment elevation acute coronary syndromes: The Task Force for the Diagnosis and Treatment of Non-ST-Segment Elevation Acute Coronary Syndromes of the European Society of Cardiology
Eur. Heart J.,
July 1, 2007;
28(13):
1598 - 1660.
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Licker, J. Diaper, and C. Ellenberger
Perioperative {beta}-Blockade: Still Not Enough for Adequate Cardioprotection!
Anesth. Analg.,
July 1, 2007;
105(1):
278 - 279.
[Full Text]
[PDF]
|
|
|
|
|
|
|
E. S. Brilakis, S. Banerjee, and P. B. Berger
Perioperative Management of Patients With Coronary Stents
J. Am. Coll. Cardiol.,
June 5, 2007;
49(22):
2145 - 2150.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. L. Grines, R. O. Bonow, D. E. Casey Jr, T. J. Gardner, P. B. Lockhart, D. J. Moliterno, P. O'Gara, and P. Whitlow
Prevention of premature discontinuation of dual antiplatelet therapy in patients with coronary artery stents: A science advisory from the American Heart Association, American College of Cardiology, Society for Cardiovascular Angiography and Interventions, American College of Surgeons, and American Dental Association, with representation from the American College of Physicians
J Am Dent Assoc,
May 1, 2007;
138(5):
652 - 655.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. M. Howard-Alpe, J. de Bono, L. Hudsmith, W. P. Orr, P. Foex, and J. W. Sear
Coronary artery stents and non-cardiac surgery
Br. J. Anaesth.,
May 1, 2007;
98(5):
560 - 574.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. Poldermans, O. Schouten, R. Vidakovic, J. J. Bax, I. R. Thomson, S. E. Hoeks, H. H.H. Feringa, M. Dunkelgrun, P. de Jaegere, A. Maat, et al.
A Clinical Randomized Trial to Evaluate the Safety of a Noninvasive Approach in High-Risk Patients Undergoing Major Vascular Surgery: The DECREASE-V Pilot Study
J. Am. Coll. Cardiol.,
May 1, 2007;
49(17):
1763 - 1769.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. G. Ellis, A. Colombo, E. Grube, J. Popma, J. Koglin, K. D. Dawkins, and G. W. Stone
Incidence, Timing, and Correlates of Stent Thrombosis With the Polymeric Paclitaxel Drug-Eluting Stent: A TAXUS II, IV, V, and VI Meta-Analysis of 3,445 Patients Followed for Up to 3 Years
J. Am. Coll. Cardiol.,
March 13, 2007;
49(10):
1043 - 1051.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. G. Memtsoudis, P. Rosenberger, and J. M. Walz
Critical Care Issues in the Patient After Major Joint Replacement
J Intensive Care Med,
March 1, 2007;
22(2):
92 - 104.
[Abstract]
[PDF]
|
|
|
|
|
|
|
S. E. Hoeks, J. J. Bax, and D. Poldermans
Indications of prophylactic coronary revascularization in patients undergoing major vascular surgery: the saga continues
Eur. Heart J.,
March 1, 2007;
28(5):
519 - 521.
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. L. Grines, R. O. Bonow, D. E. Casey Jr, T. J. Gardner, P. B. Lockhart, D. J. Moliterno, P. O'Gara, and P. Whitlow
Prevention of Premature Discontinuation of Dual Antiplatelet Therapy in Patients With Coronary Artery Stents: A Science Advisory From the American Heart Association, American College of Cardiology, Society for Cardiovascular Angiography and Interventions, American College of Surgeons, and American Dental Association, With Representation From the American College of Physicians
J. Am. Coll. Cardiol.,
February 13, 2007;
49(6):
734 - 739.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. L. Grines, R. O. Bonow, D. E. Casey Jr, T. J. Gardner, P. B. Lockhart, D. J. Moliterno, P. O'Gara, and P. Whitlow
Prevention of Premature Discontinuation of Dual Antiplatelet Therapy in Patients With Coronary Artery Stents: A Science Advisory From the American Heart Association, American College of Cardiology, Society for Cardiovascular Angiography and Interventions, American College of Surgeons, and American Dental Association, With Representation From the American College of Physicians
Circulation,
February 13, 2007;
115(6):
813 - 818.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
O. Schouten, R. T. van Domburg, J. J. Bax, P. J. de Jaegere, M. Dunkelgrun, H. H.H. Feringa, S. E. Hoeks, and D. Poldermans
Noncardiac Surgery After Coronary Stenting: Early Surgery and Interruption of Antiplatelet Therapy Are Associated With an Increase in Major Adverse Cardiac Events
J. Am. Coll. Cardiol.,
January 2, 2007;
49(1):
122 - 124.
[Full Text]
[PDF]
|
|
|
|
|
|
|
L. Broad, T. Lee, M. Conroy, S. Bolsin, N. Orford, A. Black, and G. Birdsey
Successful management of patients with a drug-eluting coronary stent presenting for elective, non-cardiac surgery
Br. J. Anaesth.,
January 1, 2007;
98(1):
19 - 22.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. Kunadian, A. R. Thornley, T. N. Babu, and J. Dunning
Should high risk patients receive clopidogrel as well as aspirin post coronary arterial bypass grafting?
Interact CardioVasc Thorac Surg,
December 1, 2006;
5(6):
755 - 760.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. G.L. Biondi-Zoccai, M. Lotrionte, P. Agostoni, A. Abbate, M. Fusaro, F. Burzotta, L. Testa, I. Sheiban, and G. Sangiorgi
A systematic review and meta-analysis on the hazards of discontinuing or not adhering to aspirin among 50 279 patients at risk for coronary artery disease
Eur. Heart J.,
November 2, 2006;
27(22):
2667 - 2674.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P.-Y. Brichon, P. Boitet, A. Dujon, J. Mouroux, C. Peillon, M. Riquet, J.-F. Velly, and H.-B. Ris
Perioperative in-stent thrombosis after lung resection performed within 3 months of coronary stenting
Eur J Cardiothorac Surg,
November 1, 2006;
30(5):
793 - 796.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J.-P. Collet and G. Montalescot
Premature withdrawal and alternative therapies to dual oral antiplatelet therapy
Eur. Heart J. Suppl.,
October 1, 2006;
8(suppl_G):
G46 - G52.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
H. B. Ward, R. F. Kelly, L. Thottapurathu, T. E. Moritz, G. C. Larsen, G. Pierpont, S. Santilli, S. Goldman, W. C. Krupski, F. Littooy, et al.
Coronary artery bypass grafting is superior to percutaneous coronary intervention in prevention of perioperative myocardial infarctions during subsequent vascular surgery.
Ann. Thorac. Surg.,
September 1, 2006;
82(3):
795 - 800.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. O. Adesanya, J. A. de Lemos, N. B. Greilich, and C. W. Whitten
Management of Perioperative Myocardial Infarction in Noncardiac Surgical Patients
Chest,
August 1, 2006;
130(2):
584 - 596.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
Top
Abstract
Methods