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K. Takegahara
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P2.03 - Poster Session/ Treatment of Locoregional Disease – NSCLC (ID 213)
- Event: WCLC 2015
- Type: Poster
- Track: Treatment of Locoregional Disease – NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P2.03-001 - Perioperative Cardiac Events in Patients with Coronary Artery Stent Undergoing Lung Resection for Lung Cancer (ID 2530)
09:30 - 09:30 | Author(s): K. Takegahara
- Abstract
Background:
Many patients with coronary artery disease (CAD) receive coronary artery stents. Some of them require major lung resection for non-small cell lung cancer (NSCLC). Patients with coronary artery stent have problems with antiplatelet therapy. After coronary artery stent, patients need dual antiplatelet therapy for a while to decrease the risk of stent thrombosis. The ACC/AHA Guidelines recommended continuation of dual antiplatelet therapy for 4 to 6 weeks after bare-metal stent (BMS) placement and 12 months for a drug-eluting stent (DES). Lung resection with discontinuation of antiplatelet therapy may increase a risk of perioperative coronary event in patients with CAD. Many patients with coronary artery disease (CAD) receive coronary artery stents. Some of them require major lung resection for non-small cell lung cancer (NSCLC). Patients with coronary artery stent have problems with antiplatelet therapy. After coronary artery stent, patients need dual antiplatelet therapy for a while to decrease the risk of stent thrombosis. The ACC/AHA Guidelines recommended continuation of dual antiplatelet therapy for 4 to 6 weeks after bare-metal stent (BMS) placement and 12 months for a drug-eluting stent (DES). Lung resection with discontinuation of antiplatelet therapy may increase a risk of perioperative coronary event in patients with CAD.
Methods:
This retrospective analysis is based on all patients with coronary artery stent requiring major lung resection for NSCLC between January 2011 and December 2013 at Nippon Medical School Hospital, Tokyo, Japan．We retrospectively examined major adverse cardiac events (MACE) and perioperative management of the patients with coronary artery stent requiring major lung resection for NSCLC.
Results:
There were thirteen patients (5.8%) with coronary artery stent in two hundred twenty six patients who underwent radical lung cancer resection. The stent group had more males (p = 0.020). There were no differences in age, histological type, operative procedure, intraoperative blood loss, pathological stage and perioperative complication. Thirty-day MACE occurred one patient in the no-stent group (0.4%). There was no patient of MACE in the stent group. Overall 3-year survival rates were 93.2% and 92.3% in the no-stent group and the stent group, respectively (p = 0.545). In the stent group, all patients were managed by cardiologists to estimate the coronary risk and preoperatively discontinued aspirin and clopidogrel. Eight patients had taken cilostazol by three days before operation day, instead of aspirin.
Conclusion:
In this retrospective study, patients with coronary stent undergoing surgical therapy for NSCLC were not at risk of for perioperative MACE. Larger prospective studies are required to conclude the risk of in-stent thrombosis in patients with coronary stent required lung resection.
