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The primary efficacy endpoint was the 30-day incidence of major adverse cardiac events (MACE), defined as the composite of cardiac death, myocardial infarction (MI) or stroke. The primary safety endpoint was the 30-day incidence of Bleeding Academic Research Consortium (BARC) bleeding \u2265 2. A total of 666 patients were included. Of these, 371 (55.7 %) discontinued their antiplatelet medication(s) (all or partly) before undergoing surgery. At 30 days, patients with perioperative discontinuation of antiplatelet therapy experienced a significantly higher incidence of MACE (7.5 % vs 0.3 %, p &lt; 0.001), cardiac death (2.7 % vs 0.3 %, p=0.027), and MI (4.0 % vs 0 %, p &lt; 0.001). After adjustment, peri-operative antiplatelet discontinuation was the strongest independent predictor of 30-day MACE (odds ratio [OR]=25.8, confidence interval [CI]=3.37\u2013198, p=0.002). Perioperative aspirin (adjusted OR 0.27, 95 % CI 0.11\u20130.71, p=0.008) was significantly associated with a lower risk of MACE. The overall incidence of BARC \u2265 2 bleeding events at 30-days was significantly higher in patients who discontinued oral antiplatelet therapy (25.6 % vs 13.9 %, p &lt; 0.001). However, after adjustment, antiplatelet discontinuation was not independently associated with BARC \u2265 2 bleeding. In conclusion antiplatelet discontinuation increases the 30-day risk of MACE, in patients with coronary stents undergoing cardiac and non-cardiac surgery, while not offering significant protection from BARC\u2265 2 bleeding.<\/jats:p>","DOI":"10.1160\/th14-05-0436","type":"journal-article","created":{"date-parts":[[2014,10,2]],"date-time":"2014-10-02T07:55:16Z","timestamp":1412236516000},"page":"272-282","source":"Crossref","is-referenced-by-count":48,"title":["Perioperative management of oral antiplatelet therapy and clinical outcomes in coronary stent patients undergoing surgery"],"prefix":"10.1160","volume":"113","author":[{"given":"Giuseppe","family":"Musumeci","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Davide","family":"Capodanno","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Corrado","family":"Lettieri","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ugo","family":"Limbruno","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppe","family":"Tarantini","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicolina","family":"Russo","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paolo","family":"Calabria","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michele","family":"Romano","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana","family":"Inashvili","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vasile","family":"Sirbu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giulio","family":"Guagliumi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Orazio","family":"Valsecchi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michele","family":"Senni","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonello","family":"Gavazzi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dominick J.","family":"Angiolillo","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberta","family":"Rossini","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2017,11,27]]},"reference":[{"key":"10.1160\/TH14-05-0436-1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2010.08.067"},{"key":"10.1160\/TH14-05-0436-2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.110.938290"},{"key":"10.1160\/TH14-05-0436-3","doi-asserted-by":"publisher","DOI":"10.1001\/jama.293.17.2126"},{"key":"10.1160\/TH14-05-0436-4","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.618066"},{"key":"10.1160\/TH14-05-0436-5","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2008.12.055"},{"key":"10.1160\/TH14-05-0436-6","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538-7836.2011.04456.x"},{"key":"10.1160\/TH14-05-0436-7","unstructured":"Wijns W, Kolh P, Danchin N, et al. 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