Management of antiplatelet therapy among patients on antiplatelet therapy for cerebrovascular or peripheral vascular diseases undergoing elective non-cardiac surgery

The perioperative management of antiplatelet therapy (APT) for patients with coronary, cerebrovascular, or peripheral vascular stents remains unclear. After percutaneous coronary intervention, American College of Cardiology (ACC) and American Heart Association (AHA) guidelines recommend delaying ele...

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Main Author: Shekelle, Paul G.
Corporate Authors: West Los Angeles VA Medical Center Evidence-Based Synthesis Program Center, United States Department of Veterans Affairs
Format: eBook
Language:English
Published: Washington, DC Department of Veterans Affairs, Health Services Research & Development Service 2017, 2017
Series:Evidence-based synthesis program
Subjects:
Online Access:
Collection: National Center for Biotechnology Information - Collection details see MPG.ReNa
Summary:The perioperative management of antiplatelet therapy (APT) for patients with coronary, cerebrovascular, or peripheral vascular stents remains unclear. After percutaneous coronary intervention, American College of Cardiology (ACC) and American Heart Association (AHA) guidelines recommend delaying elective non-cardiac surgery, ideally 6 months following drug-eluting stent placement and 30 days after bare metal stent placement. For patients on dual antiplatelet therapy (DAPT), ACC/AHA guidelines recommend continuing at least aspirin (ASA) throughout the perioperative period and restarting the P2Y12 inhibitor as soon as possible following surgery. However, this latter recommendation is based on expert opinion and was the focus of a recent ESP report. The conclusion of this report was that studies evaluating APT therapy in patients with coronary stents had significant methodologic limitations and that APT therapy likely has a small impact on perioperative bleeding and major adverse cardiac event (MACE) outcomes, compared to other clinical factors such as operative urgency and timing since stent implantation
Item Description:At head of title: QUERI.
Physical Description:1 online resource (1 PDF file (iii, 27 pages)) illustrations