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Non-Cardiac Surgery Too Soon After PCI Increases Risk of Heart Problems DALLAS -- May 5, 2010 -- Patients who can postpone non-cardiac surgery for at least 6 weeks after receiving a coronary stent are less likely to suffer reduced blood flow to the heart, myocardial infarction (MI), and death than those who have surgery sooner, according to a study published in the journal Circulation: Cardiovascular Interventions. In the broad retrospective study, researchers found that 42% of patients undergoing non-cardiac surgery within 6 weeks of stent implantation were more likely to suffer heart complications, including ischaemia, MI, and death. In comparison, these complications occurred in 13% of patients whose surgeries were performed beyond 6 weeks post-implantation. The risk of heart problems following non-cardiac surgery was even greater among patients whose stents were inserted as treatment for a recent MI (occurring in 65% of patients) than among those with stable but chronic disease (occurring in 32% of patients). The type of stent -- bare metal versus drug-eluting -- didn't affect risk, which was similar for the first 2 years after stent implantation. The researchers examined records for 1,953 patients (mean age 64 years), who had received coronary stents in Scotland between April 2003 and March 2007. They used hospital admission data and information from the Scottish Coronary Revascularisation Register. Previous studies have found that patients who underwent non-cardiac surgery within 4 to 6 weeks of bare-metal stent implantation had a greater incidence of serious heart complications. However, those studies did not clarify how long the risk persisted after stent implantation and whether it was the same in patients with drug-eluting stents. "These findings have important implications for a large number of patients," said Nicholas L.M. Cruden, PhD, University of Edinburgh, Edinburgh, Scotland. "In the current study, 4.4% of patients undergoing percutaneous coronary intervention underwent non-cardiac surgery within 1 year of coronary stent implantation." SOURCE: American Heart Association E-mail this page to a friend or colleague! To print, use this version