Perioperative outcomes of lung resection patients after coronary stent implantation

Objective: to assess the perioperative outcomes of discontinuing antiplatelet agents for patients who have undergone surgery for lung neoplasm with coronary stents. Materials and methods: from January 2015 to June 2024, 12,738 patients underwent myocardial revascularization using percutaneous coronary angioplasty (PCI) at the State Budgetary Healthcare Institution «Research Institute - Regional Clinical Hospital No. 1 n. a. prof. S.V. Ochapovsky» (RI-RCH No. 1), Krasnodar. The average age of patients was 64.1 ± 12.4 years (minimum 28, maximum 90 years). All patients were divided into two groups: Group C — coronary artery disease and concomitant diagnosis of lung tumor (94 patients); Group D — coronary artery disease without concomitant lung tumor, selected using a random number generator due to the large number of the initial cohort (150 patients). Results: all patients stopped taking antiplatelet drugs more than 5 days before lung surgery, and 67 cases stopped taking the drugs within 2 weeks. In 20 cases, the duration of treatment exceeded 2 weeks, since the surgical plan was superimposed on preoperative outpatient bronchoscopy or puncture biopsy, and the patients did not take the drug again. The overall incidence of in-hospital cardiovascular complications was 17.02%. One patient developed low-risk pulmonary embolism on the second postoperative day, two patients developed symptoms of congestive heart failure and their condition improved after treatment with diuretics and vasodilators, 10 cases of new-onset atrial fibrillation were recorded, and three patients developed hypotension requiring inotropic support in the first 5 postoperative days. Conclusions: for patients with lung neoplasms with coronary stents who required surgery, it was safe to stop oral antiplatelet drugs before lung surgery, and no serious adverse cardiovascular events or death occurred in the perioperative period.

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