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Clinical Disease
cardiac
High-impact pattern

Recent Coronary Stent & Perioperative Antiplatelet Management

DAPT interruption risk vs surgical bleeding risk in noncardiac surgery; hemodynamic and regional anesthesia considerations

A patient with a recent coronary stent on dual antiplatelet therapy presents for noncardiac surgery — balance stent thrombosis risk if DAPT is held against surgical bleeding risk if continued, keep MAP ≥60–65 mmHg, and time any neuraxial block to drug-specific intervals.

If you forget

DAPT decisions are indication- and patient-specific — never a universal hold order

Board trap
Surgeon orders 'hold all antiplatelets for 7 days preop.' Correct response: state the stent indication, stent age, surgery-specific bleeding risk, and propose drug-specific timing rather than a blanket interval.

Key numbers

  • Intraop MAP ≥60–65 mmHg target (AHA/ACC 2024 BP section)
  • Intraop SBP ≥90 mmHg target (AHA/ACC 2024 BP section)
  • Neuraxial timing is drug-specific — no generic hold interval (ASRA 2025 antithrombotic timing)
Reviewed Sep 15, 2026 for clinical accuracy by BoardsBridge Editorial Process

Uri Rozen, MD — Licensed Physician, Israel

Source guidelines: AHA ACC Perioperative Cardiovascular 2024 · AHA ACC Perioperative Cardiovascular 2024 · AHA ACC Perioperative Cardiovascular 2024 · ASRA Antithrombotic Regional Anesthesia 2025

Re-review cadence: 12 months from reviewed date.

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Related on BoardsBridge

Card ID: recent-stent-antiplatelet · Path: aba.cardiac.ischemic.recent-stent-antiplatelet

Educational reference only. Reviewed for clinical accuracy against current authoritative guidelines. Not a substitute for clinical judgment. See editorial process and the sitemap entry for this card.