Coronary disease & ACSRandomised controlled trial
Aspirin Monotherapy vs No Antiplatelet Therapy in Stable Patients With Coronary Stents Undergoing Low-to-Intermediate Risk Noncardiac Surgery
- Randomised controlled trial
Authors' conclusion
Among patients undergoing low-to-intermediate risk noncardiac surgery >1 year after stent implantation primarily with a DES, in the setting of lower-than-expected event rates, we failed to identify a significant difference between perioperative aspirin monotherapy and no antiplatelet therapy with respect to ischemic outcomes or major bleeding.
Study context
- Population
- Patients with a drug-eluting stents (DES) >1 year previously undergoing elective low-to-intermediate risk noncardiac surgery926 in modified ITT
- Participants
- 1,010 patients
- Comparison
- Aspirin monotherapy vs no antiplatelet therapy before noncardiac surgery
- Aspirin monotherapyn = 462
- No antiplatelet therapyn = 464reference
- Primary endpoint
- Composite of:
- All-cause death
- MI
- Stent thrombosis
- Stroke
- Follow-up
- Between 5 days before and 30 days after noncardiac surgery
Primary result
As reported in the abstract
Difference
−0.2 percentage points
95% CI −1.3 to 0.9
P > 0.99
Events by treatment group
Aspirin monotherapy vs No antiplatelet therapy
difference −0.2 percentage points (95% CI −1.3 to 0.9); P > 0.99
Further findings
Stent thrombosis
- No stent thrombosis in either group
Safety
Major bleeding
P = 0.39
Minor bleeding
P = 0.027
Original publication
Aspirin Monotherapy vs No Antiplatelet Therapy in Stable Patients With Coronary Stents Undergoing Low-to-Intermediate Risk Noncardiac Surgery. J Am Coll Cardiol. Published 31 August 2024. doi:10.1016/j.jacc.2024.08.024
Summarised from the published abstract; every number is checked against it