AI Article Synopsis
- Effective management of acute myocardial infarction (AMI) after oncologic neurosurgery involves careful balancing of heart risks and bleeding complications.
- There's a lack of solid human studies to determine the best time to start antiplatelet or anticoagulant therapy post-surgery.
- For cancer patients with AMI after surgery, a staged approach to percutaneous coronary intervention (PCI) may help preserve heart function while reducing bleeding risks, supported by genetic testing for platelet response.
Article Abstract
The management of perioperative acute myocardial infarction (AMI) following oncologic neurosurgery requires balancing competing risks of myocardial ischemia and postoperative bleeding. There are limited human data to establish the safest timing of antiplatelet or anticoagulation therapy following neurosurgical procedures. For patients with malignancy experiencing AMI in the acute postoperative period, staged percutaneous coronary intervention (PCI) with upfront coronary aspiration thrombectomy followed by delayed completion PCI may offer an opportunity for myocardial salvage while minimizing postoperative bleeding risks. CYP2C19 genotyping and platelet aggregation studies can help confirm adequate platelet inhibition once antiplatelet therapy is resumed.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11093953 | PMC |
| http://dx.doi.org/10.1007/s40119-024-00356-7 | DOI Listing |
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