Myocardial infarction (MI) is the most common major vascular event that occurs after planned non-cardiac surgery. Multiple strategies have been assessed to try and reduce the rates of peri-operative MI, but few have consistently demonstrated substantial benefit. With a pro-thrombotic environment and marked sympathetic activation thought to play etiological roles, in the POISE-2 study, the […]
Tag: noncardiac surgery
β-blockers beneficial in some, but not all, ischemic heart disease patients undergoing non-cardiac surgery
Whether β-blockers reduce adverse events among patients with stable ischemic heart disease (IHD) undergoing non-cardiac surgery remains in debate. In this Danish study, the authors retrospectively identified 28,263 IHD patients who underwent non-cardiac surgeries and examined the association between pre-procedural β-blockers use and a major adverse cardiovascular event (MACE) defined as 30-day cardiac death, myocardial […]
Stent type and interrupted anti-platelet therapy does not correlate with adverse events after non-cardiac surgeries
Guidelines recommend delaying elective surgery in patients with drug eluting stent (DES) for one year after stent implantation to allow completion of 1 year of dual anti-platelet therapy (DAPT) without interruption. This recommendation is based on expert consensus and results in several clinical questions, including whether it is preferable to use a bare metal stent […]
Beta-blockers could increase risk in noncardiac surgery
Many trials have suggested a protective role for beta-blockade in noncardiac surgery, and the current ACC/AHA guidelines recommend their use in high-risk patients. However, preliminary results from the recent POISE (Perioperative Ischemic Evaluation (POISE) trial showed a higher incidence of total deaths and stroke in patients receiving peri-operative bera-blockade compared with placebo. […]