The timing of surgical interventions following the implantation of coronary drug-eluting stents in patients undergoing gastrointestinal cancer surgery: A multicenter retrospective cohort study

Background The guidelines recommending a minimum deferral of six months for non-cardiac surgeries following drug-eluting stent percutaneous coronary intervention (DES-PCI) do not adequately address the requirements for individuals undergoing gastrointestinal cancer surgery (GCS). We aim to investigate the optimal timing for surgical interventions to maximize patient benefit. Methods The study encompassed 2,501 patients treated from January 2017 to December 2021, all of whom underwent GCS within one year after DES-PCI. We conducted an analysis by comparing the occurrence of Major Adverse Cardiovascular Events (MACEs) within 30 days post-surgery at different time points. Results This study enrolled a total of 2501 participants with meticulously recorded data who underwent DES-PCI and subsequently underwent GCS within one year post-implantation. The incidence rate of MACEs is 14.2%, including MI(5.1%), HF(5.8%), IS(3.2%), Cardiac death(0.2%) across all patients in this study. The threshold probability was determined using the Youden Index, resulting in a value of 0.320, corresponding to a “Time of surgery value” of 87. Significant statistical differences were observed in the occurrence rates of MACEs for adjacent time intervals at 30 days (p < 0.001), 90 days (p < 0.009), and 180 days (p < 0.001). Conclusions The timing of surgical intervention following DES-PCI significantly influences the occurrence of MACEs at 1 month, 3 months, and 6 months. GCS may be appropriately advanced within the 6-month timeframe, but with the exception of emergency, efforts should be made to defer them beyond the initial month. ### Competing Interest Statement The authors have declared no competing interest. ### Clinical Trial This study is a retrospective study and does not belong to registered clinical trials or prospective intervention studies. ### Funding Statement This study has been supported by the following funding, and it is hereby declared that: Beijing Technology Program provided funding for this research., China (Z201110008320023).We solemnly declare that the funding institution has not exerted any improper influence on research design, data collection, analysis, and opinion presentation. The viewpoints and conclusions in the study belong entirely to the author and do not represent the position of the funding institution. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The authors assert that all procedures contributing to this work comply with the ethical standards of the relevant national and institutional committees on human experimentation and with the Helsinki Declaration of 1975, as revised in 2008. This study received approval from the Research Ethics Committee of the People's Liberation Army General Hospital, denoted by approval No. S2023-630, and did not require informed patient consent. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All data cited in this paper can be provided and backed up to ensure data integrity and traceability. If necessary, the author will provide relevant data and additional information to support the validation and reproduction of the research results. Please contact the author for access permissions and detailed information on the relevant data. We are committed to promoting scientific sharing and transparency to advance research in the field of biotechnology.