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Research Letter | Association of VA Surgeons

Frequency of Surgery Cancellations Associated With Myocardial Infarction or Death 6 Months After Coronary Stent Placement

Laura A. Graham, MPH1,2; Robert H. Hollis, MD1,2; Joshua S. Richman, MD, PhD1,2; Mary T. Hawn, MD, MPH1,2,3
[+] Author Affiliations
1Birmingham VA Medical Center, Birmingham, Alabama
2Department of Surgery, University of Alabama at Birmingham
3Department of Surgery, Stanford University, Stanford, California
JAMA Surg. 2015;150(12):1199-1201. doi:10.1001/jamasurg.2015.3078.
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This study hypothesizes that surgery cancellations are more frequent in the first 6 months following the placement of a drug-eluting stent and that a higher proportion of early cancellations are associated with acute myocardial infarction or death.

Observational studies report a decreased risk of postoperative adverse cardiac events among patients following percutaneous coronary intervention (PCI) when surgery is more than 6 months after coronary stent placement14; however, the frequency and timing of surgery cancellations due to preoperative adverse cardiac events or death in the interval between the scheduling of the procedure and the procedure itself is unknown. Changes in medical condition may account for 28% of surgery cancellations.5 In addition, prior research on adverse postoperative events may be biased by the unavoidable selection criterion that a patient must first experience surgery in order to be studied.6 With little information on the frequency and factors associated with surgery cancellations following PCI, it is difficult to quantify the impact of this bias. We hypothesize that surgery cancellations are more frequent in the first 6 months following the placement of a drug-eluting stent (DES) and that a higher proportion of early cancellations are associated with acute myocardial infarction (MI) or death.

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Percentage of Surgery Cancellations Related to Death or Myocardial Infarction (MI) Among All Surgery Cancellations by Time Since Coronary Stent Placement
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