Preoperative evaluation of patients with possible coronary artery disease.
During noncardiac surgery, patients may be at risk for developing cardiac events, related to underlying coronary artery disease. Therefore, perioperative cardiac complications remain an area of clinical interest and concern in patients undergoing noncardiac surgery. Over the years, perioperative risk assessment has evolved significantly to detect surgical patients with myocardium at risk due the coronary artery disease. In addition, many efforts have been made to reduce the cardiac risk of patients undergoing noncardiac surgery. The present review article will focus on the definition of high cardiac risk surgery and will discuss patient-related cardiac risk factors. In addition, the preoperative cardiac tests available to detect patients with coronary artery disease and strategies to reduce perioperative cardiac risk, as recommended in most recent perioperative guidelines, will be outlined.
Flu
Willem-Jan
WJ
Department of Vascular Surgery, Erasmus Medical Center, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands.
van Kuijk
Jan-Peter
JP
Hoeks
Sanne
S
Bax
Jeroen J
JJ
Poldermans
Don
D
D015415:Biomarkers; D016001:Confidence Intervals; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D004562:Electrocardiography; D013502:General Surgery; D006305:Health Status Indicators; D006801:Humans; D009206:Myocardium; D049268:Positron-Emission Tomography; D011300:Preoperative Care; D018570:Risk Assessment; D012307:Risk Factors; D040242:Risk Reduction Behavior; D013997:Time Factors; D015899:Tomography, Emission-Computed, Single-Photon; D014463:Ultrasonography; D014481:United States
D015415:Biomarkers