A retrospective cohort study in the US found that surgery in patients with a coronary stent placed for myocardial infarction (MI) was associated with increased postoperative major adverse cardiac events (MACE) rates compared with other stent indications. The risk declined over time from stenting, and delaying surgery up to 6 months in this cohort of patients with stents may be important regardless of stent type. The study included 26 661 patients (median age, 68 [61.0-76.0] years; 98.4% male; 88.1% white) who underwent 41 815 noncardiac surgical procedures within 24 months following coronary stent placement between January 1, 2000, and December 31, 2010. The stent indication was MI in 32.8% of the procedures, unstable angina in 33.8%, and non-acute coronary syndrome (ACS) in 33.4%. Postoperative MACE rates were significantly higher in the MI group (7.5%) compared with the unstable angina (2.7%) and non-ACS (2.6%) groups. When surgery was performed within 3 months of stenting, adjusted odds of MACE were significantly higher in the MI group compared with the non-ACS group. This risk decreased over time, although it remained significantly higher at 12 to 24 months from stenting. Stent type was not significantly associated with MACE regardless of indication. Source: http://archsurg.jamanetwork.com/
美国一项回顾性群组研究发现，与其他冠脉支架适应症相比，因心梗置入支架与术后主要不良心脏事件率增加有关。风险随支架置入时间而下降，提示对该组支架置入患者推迟手术达6个月的重要性，无论支架类型。该研究共包括2000年1月1日至2010年12月31日间的26661例患者（平均年龄，68 [61.0-76.0]岁; 98.4％为男性，88.1％为白人），在冠脉支架置入24个月内经受41 815例非心脏外科手术。支架指征分别为心梗32.8％，不稳定型心绞痛33.8％，非急性冠脉综合征33.4％。与不稳定型心绞痛（2.7％）和非急性冠脉综合征（2.6％）组相比，心梗组术后主要不良心脏事件率显著更高（7.5％）。 支架置入3个月内进行手术，与非急性冠脉综合征组相比，心梗组经校正的主要不良心脏事件可能性显著更高。该风险随时间而减小，但支架置入后12至24个月仍然显著增高。无论支架指征，支架类型与主要不良心脏事件无显著相关。来源：http://archsurg.jamanetwork.com/