View source for Recommendations for Perioperative Management–Timing of Elective Noncardiac Surgery in Patients Treated With PCI and DAPT


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{{PCI}}
==2016 ACC/AHA Guideline Focused Update on Duration of Dual Antiplatelet Therapy in Patients With Coronary Artery Disease<ref name="pmid27751237">{{cite journal| author=Levine GN, Bates ER, Bittl JA, Brindis RG, Fihn SD, Fleisher LA et al.| title=2016 ACC/AHA guideline focused update on duration of dual antiplatelet therapy in patients with coronary artery disease: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. | journal=J Thorac Cardiovasc Surg | year= 2016 | volume= 152 | issue= 5 | pages= 1243-1275 | pmid=27751237 | doi=10.1016/j.jtcvs.2016.07.044 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27751237  }} </ref>==
===Recommendations for Perioperative Management–Timing of Elective Noncardiac Surgery in Patients Treated With PCI and DAPT=== 
{|class="wikitable" style="width:80%"
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| colspan="1" style="text-align:center; background:LightGreen"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]]

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| bgcolor="LightGreen"|<nowiki>"</nowiki>'''1.'''Elective noncardiac surgery should be delayed 30 days after BMS implantation and optimally 6 months after DES
implantation''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B-NR]])''<nowiki>"</nowiki>

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| bgcolor="LightGreen"|<nowiki>"</nowiki>'''2.'''In patients treated with DAPT after coronary stent implantation who must undergo surgical procedures that
mandate the discontinuation of P2Y12 inhibitor therapy, it is recommended that aspirin be continued if possible and
the P2Y12 platelet receptor inhibitor be restarted as soon as possible after surgery''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C-EO]])''<nowiki>"</nowiki>
|}
{|class="wikitable" style="width:80%"
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| colspan="1" style="text-align:center; background:LemonChiffon"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIa]]
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|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.'''When noncardiac surgery is required in patients currently taking a P2Y12 inhibitor, a consensus decision among treating
clinicians as to the relative risks of surgery and discontinuation or continuation of antiplatelet therapy can be useful.''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C-EO]])''<nowiki>"</nowiki>
|}
{|class="wikitable" style="width:80%"
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| colspan="1" style="text-align:center; background:LemonChiffon"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIb]]
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|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.'''Elective noncardiac surgery after DES implantation in patients for whom P2Y12 inhibitor therapy will need to be
discontinued may be considered after 3 months if the risk of further delay of surgery is greater than the expected risks of stent thrombosis''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C-EO]])''<nowiki>"</nowiki>
|}
{|class="wikitable" style="width:80%"
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|colspan="1" style="text-align:center; background:LightCoral"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class III]] (No Benefit)
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|bgcolor="LightCoral"|<nowiki>"</nowiki>'''1.'''Elective noncardiac surgery should not be performed within 30 days after BMS implantation or within 3 months
after DES implantation in patients in whom DAPT will need to be discontinued perioperatively''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B-NR]])''
<nowiki>"</nowiki>
|}