▲ Professor Jung-Min Ahn is consulting a patient who underwent percutaneous coronary intervention (PCI).

During a percutaneous coronary intervention (PCI), aspirin is taken to prevent blood clots from forming at the site where a stent was inserted. However, aspirin’s blood-thinning properties were known to possibly cause bleeding complications during surgeries for other diseases, such as tooth extraction, endoscopic procedures for polyp removal, or cancer surgeries. This raised the need for guidelines on aspirin use before and after other surgeries.

A research team led by Professors Jung-Min Ahn and Do-Yoon Kang of the Division of Cardiology at Asan Medical Center recently published a study suggesting that patients who have undergone percutaneous coronary intervention (PCI) with drug-eluting stents (DES) more than a year prior may safely discontinue aspirin temporarily before non-cardiac surgeries, including those for cancer, dental work, knee, and hip procedures. PCI with DES involves inserting a drug-coated stent into a narrowed part of the coronary artery.

The research team studied 926 patients from 30 institutions across South Korea, India, and Türkiye who had undergone PCI with DES at least one year prior between 2017 and 2024. To analyze treatment efficacy, the patients were divided into two groups: 462 patients who continued to take aspirin before and after non-cardiac surgery and 464 patients who stopped taking all antiplatelet medications, including aspirin, five days before non-cardiac surgery.

▲ (from the left) Professors Jung-Min Ahn and Do-Yoon Kang

Their results indicated that the rate of significant clinical events, including death, myocardial infarction, thrombosis, or stroke, was 0.6% among those who continued aspirin and 0.9% among those who discontinued it. Statistically, this difference was not significant. Furthermore, there were no cases of thrombosis in either group, and no significant difference was found in the rates of major bleeding. Minor bleeding, however, was slightly more frequent in the aspirin group, occurring in 14.9% of cases, compared to 10.1% in the group that discontinued aspirin.

Professor Ahn stated, “We obtained important study findings showing that it is safe to discontinue aspirin temporarily when performing non-cardiac surgery in patients who underwent percutaneous coronary intervention (PCI) with drug-eluting stents (DES).”

The research findings were published in the ‘Journal of the American College of Cardiology,’ a globally-renowned journal on cardiology, and presented at the ESC Congress 2024, recently held in London, UK.