Perioperative management of the patient with a coronary artery stent.

1093 November 2014 W ITH the advent of percutaneous coronary intervention (PCI), specifically the bare-metal stent (BMS) and subsequently, the drug-eluting stent (DES), the role of interventional cardiology in coronary revascularization has greatly increased.1 An estimated 600,000 coronary artery stents are placed annually in the United States for the management of acute and chronic coronary artery disease.1 Given the aging US population and its increasing prevalence of coronary artery disease, the use of stents will likely continue to grow. The cumulative incidence of noncardiac surgery after coronary stenting is more than 10% at 1 yr and more than 20% at 2 yr.2 Both the safe timing of noncardiac surgery and the need for continuing chronic antiplatelet therapy for coronary artery stents to mitigate a perioperative major adverse cardiac event (MACE) remains controversial.3