Timing is Everything: Delaying Noncardiac Surgery After a Heart Procedure Reduces Risks
Timing is Everything: Delaying Noncardiac Surgery After a Heart Procedure Reduces Risks
1. Study Overview
• A study published in JACC: Advances suggests that waiting at least 100 days after cardiac surgery before undergoing noncardiac surgery reduces the risk of adverse outcomes.
2. Research Background
• Preoperative cardiovascular diagnostics (e.g., stress tests, echocardiograms, coronary angiography) are commonly used to assess surgical risk.
• With an aging population and increased use of cardiac interventions, many patients undergo noncardiac surgery after heart procedures.
• However, the optimal timing for noncardiac surgery post-cardiac intervention remains unclear.
3. Study Data & Patient Groups
• The research analyzed 1.3 million+ adult patients (2016–2022) from the Nationwide Readmissions Database.
• All patients had undergone:
• Coronary artery bypass grafting (CABG)
• Heart valve repair or replacement
• 1.5% of these patients required a noncardiac surgery afterward.
• Patients were divided into two groups:
• Early patients: Noncardiac surgery within 99 days (52.1%).
• Late patients: Noncardiac surgery after 100 days (47.9%).
4. Key Findings: Adverse Event Risk
• Major adverse events (MAEs) included:
• In-hospital mortality, cardiac events, stroke, kidney injury, bleeding, infection, and respiratory complications.
• Early surgery patients had higher risk of MAEs:
• 35.6% of early patients experienced at least one adverse event.
• 23.3% of late patients experienced an adverse event.
• Even after adjusting for risk factors, late patients still had better outcomes.
5. Clinical Implications
• Delaying noncardiac surgery for at least 100 days post-cardiac surgery is associated with significantly lower risks.
• This applies across different surgical risk categories, regardless of the urgency of the noncardiac procedure.
• Further research is needed to identify which patients benefit the most from delayed noncardiac surgery.
6. Conclusion
• Physicians should carefully consider timing when planning noncardiac surgery for patients with recent cardiac interventions.
• A 100-day waiting period may be the safest approach to minimize complications and improve patient outcomes.
JACC Adv. 2025 Apr, 4 (4) 101668
