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P Barash, S Akhtar  British Journal of Anaesthesia 

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Presentation on theme: "P Barash, S Akhtar  British Journal of Anaesthesia "— Presentation transcript:

1 Coronary stents: factors contributing to perioperative major adverse cardiovascular events 
P Barash, S Akhtar  British Journal of Anaesthesia  Volume 105, Pages i3-i15 (December 2010) DOI: /bja/aeq318 Copyright © 2010 The Author(s) Terms and Conditions

2 Fig 1 Relative contributions of key hazards associated with major adverse cardiovascular events in patients with coronary stents. These form the framework for clinical decision-making. Contributions are apportioned based on the authors’ review of the literature. Other risk factors for coronary stent thrombosis are listed in Table 1. British Journal of Anaesthesia  , i3-i15DOI: ( /bja/aeq318) Copyright © 2010 The Author(s) Terms and Conditions

3 Fig 2 The metabolic pathways involved in generating the active metabolite of clopidogrel from the parent or prodrug. The dependence on the hepatic cytochrome system contributes to the genetically based bioavailability of the active compound. Reproduced with permission, copyright ©2009 Massachusetts Medical Society. All rights reserved.53 British Journal of Anaesthesia  , i3-i15DOI: ( /bja/aeq318) Copyright © 2010 The Author(s) Terms and Conditions

4 Fig 3 The concept of high-risk pharmacokinetics is the study of drug toxicity when the concentrations of a drug are dependent on the variable activity of a single metabolic pathway. Reproduced with permission. Roden and Stein.56 British Journal of Anaesthesia  , i3-i15DOI: ( /bja/aeq318) Copyright © 2010 The Author(s) Terms and Conditions

5 Fig 4 The interval from percutaneous coronary intervention to operation is inversely related to the adverse complication rate. This is particularly true in emergency surgery within 30 days of coronary stent implantation. Note some of the data points represent series in which coronary angioplasty plus coronary stents were also employed. Reproduced with permission. Schouten and colleagues.96 British Journal of Anaesthesia  , i3-i15DOI: ( /bja/aeq318) Copyright © 2010 The Author(s) Terms and Conditions


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