Coronary disease & ACS

Aspirin Monotherapy vs No Antiplatelet Therapy in Stable Patients With Coronary Stents Undergoing Low-to-Intermediate Risk Noncardiac Surgery

J Am Coll CardiolPublished Randomised controlled trial

Primary resultResult — go to the resultDifference −0.2 percentage points 95% CI −1.3 to 0.9

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 monotherapyvs No antiplatelet therapy
difference −0.2 percentage points (95% CI −1.3 to 0.9); P > 0.99

Further findings

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

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