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190314s20192019 xxu||||| |||| 00| 0 eng d
0258-851X
10.21873/invivo.11519 [doi]
33/2/621 [pii]
Ovid MEDLINE(R)
30804150
Perioperative Management of Antiplatelet Therapy in Patients With History of Coronary Artery Disease Undergoing Surgery for Esophageal Cancer: A Single-center Experience.
In Vivo. 33(2):621-626, 2019 Mar-Apr.
In Vivo. 33(2):621-626, 2019 Mar-Apr.
In vivo (Athens, Greece)
2019
FY2019
ppublish
2019-03-14
AIM: To present the experience of the upper Gastrointestinal Unit of the Surgical Department of National and Kapodistrian University of Athens in order to inform surgeons of the exact harms and benefits associated with their decisions concerning management of antiplatelet therapy.
CONCLUSION: It is a reasonable approach to discontinue antiplatelet therapy for more than 7 days before surgery, especially in such a population of patients with esophageal cancer that require complex operations with high bleeding risk.
Copyright(c) 2019, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.
MATERIALS AND METHODS: This was a single-center study of patients who underwent surgery for esophageal cancer and had concomitant coronary artery disease from 1/1/2005 to 31/7/2017. Patients were divided into two cohorts based on when their antiplatelet therapy was stopped (<7 vs. >=7 days). Esophageal cancer was classified as esophageal only or as Siewert type I, II, or III based on tumor location at the gastroesophageal junction. A univariate logistic regression model was developed to assess the relationship between baseline variables and myocardial infraction, mortality, bleeding and stroke after the operation. For all tests, differences with a value of p<0.05 were considered significant.
RESULTS: During the study period, 135 esophagectomies were performed for esophageal cancer. Almost 17% of them had concomitant coronary artery disease medically managed with antiplatelet therapy. No difference was found in terms of myocardial infarction, stroke or severe bleeding events between patients that stopped antiplatelet therapy for more or less than 7 days before esophagectomy.
English
*Coronary Artery Disease/dt [Drug Therapy]
*Esophageal Neoplasms/dt [Drug Therapy]
*Esophageal Neoplasms/su [Surgery]
*Platelet Aggregation Inhibitors/ad [Administration & Dosage]
Aged
Clopidogrel/ad [Administration & Dosage]
Coronary Artery Disease/co [Complications]
Coronary Artery Disease/pp [Physiopathology]
Esophageal Neoplasms/co [Complications]
Esophageal Neoplasms/pp [Physiopathology]
Female
Hemorrhage/pp [Physiopathology]
Humans
Male
Middle Aged
Perioperative Care
Platelet Aggregation Inhibitors/ae [Adverse Effects]
Risk Assessment
Risk Factors
Stents/ae [Adverse Effects]
Ticlopidine/ad [Administration & Dosage]
Ticlopidine/ae [Adverse Effects]
MedStar Washington Hospital Centerumar
Medicine/General Internal Medicine
Journal Article
Jonnalagadda, Anil K
Bakopoulos A, Domi V, Jonnalagadda AK, Kapelouzou A, Kokkinidis DG, Liakakos T, Mpaili E, Schizas D, Theochari CA, Theochari NA
https://dx.doi.org/10.21873/invivo.11519
https://dx.doi.org/10.21873/invivo.11519
ART
Article
0
0
0
0
Article
authcat
authcat
2019-03-14
0
30804150
30804150
2019-03-14
2019-03-14
ART
4117
4117