Objective: To analyze the relationship between early anti-coagulative therapy and acute coronary syndrome (ACS) in the high-risk patients who have suffered percutaneous coronary intervention (PCI) recently during perioperative period of non-cardiac surgery.
Methods: Patients who underwent scheduled non-cardiac surgery in our hospital from May 2009 to May 2011 were reviewed, of whom, 135 patients had suffered PCI therapy within 1 year, insisting on the treatment by taking aspirin and clopidogrel (plaix) orally. These patients were administrated with heparin replacement treatment before scheduled surgeries. After surgeries, patients were divided into non-anticoagulative therapy group (63 cases), low molecular weight heparin (LMWH)-anticoagulative therapy group (36 cases) and unfractionated heparin (UFH)-anticoagulative therapy group (38 cases). The occurrence of ACS and hemorrhage in 3 days after operations was evaluated.
Results: Of the 135 patients, 9 developed ACS in 3 days in non-anticoagulative therapy group and none in other 2 groups (P<0.01). No statistical difference among the 3 groups in quantity of the blood transfusion was found.
Conclusion: After scheduled non-cardiac surgeries, early and effective anticoagulative therapy administrated in the high-risk patients who have suffered PCI recently can obviously lower peri-operative incidence of acute coronary syndrome, and can be incapable of increasing risk of post-operative hemorrhage.