Abstract
<title>Abstract</title> <p> <bold>Objective</bold> To evaluate the safety of lung resection surgery in patients with lung cancer and concomitant coronary heart disease with prior stent implantation, and to analyze the incidence and risk factors of postoperative complications and major adverse cardiovascular events (MACE). <bold>Methods</bold> A retrospective analysis was conducted on clinical data from 273 patients with lung cancer and concomitant coronary heart disease with prior stent implantation who underwent lung resection surgery at the Department of Thoracic Surgery, Peking Union Medical College Hospital, from January 2018 to December 2023. Data collected included demographic characteristics, comorbidities, coronary heart disease treatment (time of stent implantation, antiplatelet drugs, statins, beta-blockers), surgery-related factors, and postoperative complications. The Chi-square test or Fisher's exact test was used to compare categorical variables, and the Mann-Whitney U test was used for continuous variables. Factors associated with overall complications and MACE (including myocardial infarction and new-onset postoperative atrial fibrillation) were analyzed. <bold>Results:</bold> Among the 273 patients, the overall postoperative complication rate was 17.6% (48 cases). The MACE rate was 5.9% (16 cases), including 9 cases (3.3%) of myocardial infarction and 7 cases (2.6%) of new-onset postoperative atrial fibrillation. Univariate analysis showed that pulmonary disease was significantly associated with overall complications (P = 0.0174). Statin use was significantly associated with overall complications (P = 0.0115). Factors such as antiplatelet drugs, beta-blockers, gender, smoking history, hypertension, diabetes, cerebrovascular disease, surgical procedure, operative duration, blood loss, and ICU admission showed no statistically significant association with complications or MACE (P > 0.05). <bold>Conclusion:</bold> Lung resection surgery is generally safe for lung cancer patients with coronary heart disease and prior stent implantation. Statin use was associated with a lower overall complication rate against overall postoperative complications. Pulmonary disease is an independent risk factor for postoperative complications. The period from six months to one year after stent implantation may represent a risk window for cardiovascular events, requiring enhanced perioperative management. </p>