The prospective multicentre MARS registry followed 132 post-PCI patients on dual antiplatelet therapy undergoing moderate- to high-risk surgery, including 53 cardiac operations. From 14 days before to 30 days after surgery, net adverse cardiovascular events occurred in 18.9% after cardiac versus 10.1% after non-cardiac surgery (p=0.17). Major bleeding occurred in 5.3%, with no cardiovascular deaths reported. Cangrelor bridging, used in 12 patients, was not independently associated with the composite of cardiovascular events or major bleeding (adjusted OR 2.18, 95% CI 0.43–8.71).
This registry describes perioperative event rates but does not establish whether antiplatelet bridging improves outcomes. The imprecise adjusted estimate leaves substantial uncertainty about its association with adverse events.
Study limitation: The small observational cohort, only 12 bridged patients, and potential confounding by indication limit comparisons between antiplatelet strategies.
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