Assessment of cardiovascular disease

G. M. Flood, L. Fleisher

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

The American College of Cardiology Foundation (ACCF)/American Heart Association (AHA) and the European Society of Cardiology (ESC) (endorsed by the European Society of Anaesthesiology [ESA]) have published guidelines on perioperative cardiovascular evaluation before non-cardiac surgery [1,2]. The ACCF/AHA 2009 guidelines were updated from the 2007 guidelines with regard to perioperative β-blockade and the ESC guideline dates from 2009. These two guidelines differ in their advice on β-blockade perioperatively, and this area of perioperative risk prevention has recently been thrown into contention yet again with concerns over the validity of some published and widely cited European work. Cardiovascular disease and perioperative major adverse cardiac events (MACE) carry a considerable burden of morbidity and mortality during non-cardiac surgery. In the European Surgical Outcomes Study (EuSOS), in-hospital mortality after inpatient non-cardiac surgery varied across Europe and on average was higher than previously documented at 4.0% [3]. The VISION trial included 15 133 patients undergoing non-cardiac surgery with 1.9% thirty-day overall mortality [4]. The Perioperative Ischemia Events (POISE) Trial showed that patients with or at risk of atherosclerotic disease undergoing inpatient non-cardiac surgery had an overall mortality of 2.3%–3.1%, with cardiovascular death accounting for approximately 60% of these mortalities [5].

Original languageEnglish (US)
Title of host publicationAnesthesia and Perioperative Care of the High-Risk Patient, Third Edition
PublisherCambridge University Press
Pages30-49
Number of pages20
ISBN (Electronic)9781139629362
ISBN (Print)9781107690578
DOIs
StatePublished - Jan 1 2014

ASJC Scopus subject areas

  • Medicine(all)

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