Abstract
Perioperative cardiac complications pose the greatest risk to the estimated 100 million people undergoing non-cardiac surgery each year. Most of these complications are related to underlying pre-existing coronary artery disease (CAD). For over 40 years researchers have been studying perioperative cardiac risk and how best to estimate it. The goal of improved risk stratification is important for allowing accurate informed decision-making, both by the patient and their physicians. Risk stratification has taken on an important role in clinical decision-making, helping physicians decide in which patients additional medical therapies, such as coronary revascularization or perioperative beta-blockers, are necessary. Meta-analysis has found a significant improvement in the positive predictive value (PPV) for perioperative cardiac outcome with stress testing over that with clinical risk score alone. However, evidence is mounting that with the use of perioperative beta-blockers, the majority of intermediate and high-risk patients can safely undergo even major vascular surgery without further cardiac testing.
Original language | English (US) |
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Pages (from-to) | 1-21 |
Number of pages | 21 |
Journal | Best Practice and Research: Clinical Anaesthesiology |
Volume | 22 |
Issue number | 1 |
DOIs | |
State | Published - Mar 2008 |
Externally published | Yes |
Keywords
- CABG
- CAD
- MI
- PVD
- anesthesia
- beta-blockers
- cardiac catheterization
- cardiac risk stratification
- cardiac stent
- cardiac stress testing
- ischemic heart disease
- perioperative beta-blockers
- prophylactic coronary revascularization
- stress test
- vascular surgery
ASJC Scopus subject areas
- Anesthesiology and Pain Medicine