|
ACC/AHA
Guideline Update for Perioperative Cardiovascular Evaluation
for Noncardiac Surgery
A
Report of the American College of Cardiology/American
Heart Association Task Force on Practice Guidelines
(Committee to Update the 1996 Guidelines on Perioperative
Cardiovascular Evaluation for Noncardiac Surgery)
New
Table 9a. Studies Reporting the Clinical Outcome
of Patients Undergoing Noncardiac Surgery After a Percutaneous
Coronary Intervention
|
Study
Authors |
Year
Published
|
No.
of Patients who Underwent PCI
|
Time
From PCI to Surgery
|
Perioperative
Mortality, %
|
Perioperative
infarction rate, %
|
Comments
|
|
Huber
et al (179)
|
1992
|
50
|
9
days (mean)
|
1.9
|
5.6
|
CABG
needed after balloon angioplasty in 10% of pts.
No control group for comparison.
|
|
Elmore
et al (180)
|
1993
|
14
|
10
days (mean)
|
0
|
0
|
Very
small study. Event rate in pts. treated with CABG
or balloon angioplasty less than in control group.
Angioplasty pts. had fewer risk factors than pts.
undergoing CABG.
|
|
Allen
et al (181)
|
1991
|
148
|
338
days
(mean)
|
2.7
|
0.7
|
No
increase in events if surgery performed within
90 days of PTCA.
|
|
Gottleib
et al (296)
|
1998
|
194
|
11
days
(median)
|
0.5
|
0.5
|
Only
vascular surgeries included.
|
|
Possner
et al (298)
|
1999
|
686
|
1
year (median)
|
2.6
|
2.2
|
Pts.
who had undergone PCI had a similar frequency
of death and MI but half the angina and HF of
matched pts. with CAD who had not undergone PCI.
Event rates were much higher if PCI had been performed
within 90 days.
|
|
Kaluza
et al
(301)
|
2000
|
40
|
13
days
(mean)
|
20
|
16.8
|
The
only study in which stents were used. Mortality
was 32% among pts. operated on less than 12 days
after stent placement vs. 0 in pts. operated on
12 to 30 days after PCI.
|
|
Hassan
et al
(303)
|
2001
|
251
|
29
months
(median)
|
0.8
|
0.8
|
Among
pts. who received PCI in BARI, outcome after noncardiac
surgery was equivalent to that of BARI pts. who
had received CABG.
|
BARI
indicates Bypass Angioplasty Revascularization Investigation;
CABG, coronary artery bypass surgery; CAD, coronary
artery disease; HF, heart failure, MI, myocardial infarction;
PCI, percutaneous coronary intervention; PTCA, percutaneous
transluminal coronary angioplasty; Pts, patients.
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