[Strategies of preoperative evaluation and risk reduction in patients undergoing invasive procedures in the view of recent European Society of Cardiology guidelines].
In this article we summarise recent European Society of Cardiology guidelines on perioperative evaluation and management of patients undergoing invasive non-cardiac procedures. Close attention is paid to pharmacological methods of risk reduction including beta-blockers, statins, aspirin and angiotensin converting enzyme inhibitors. Simple, stepwise and evidence-based algorithm for patient evaluation is presented. We discuss the need for excessive diagnostic tests and coronary revascularisation before the procedure. Time frame for stopping dual antiplatelet therapy following percutaneous coronary interventions, methods of glycaemic control and bridging protocol for patients on oral anticoagulants are also provided. We emphasise the importance of prompt implementation of the above guidelines as the number of surgical procedures being performed in high risk patients (including the elderly) constantly rises.
Niewiński
Piotr
P
pnsky@poczta.onet.pl
Ponikowski
Piotr
P
D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage; D000368:Aged; D000465:Algorithms; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage; D001241:Aspirin / Q000008:administration & dosage; D013504:Cardiovascular Surgical Procedures / Q000379:methods* / Q000592:standards*; D002985:Clinical Protocols; D005060:Europe; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage; D054539:Medication Therapy Management / Q000592:standards*; D019990:Perioperative Care / Q000379:methods; D017410:Practice Guidelines as Topic; D011292:Premedication; D011300:Preoperative Care / Q000379:methods*; D040242:Risk Reduction Behavior; D012955:Societies, Medical
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D001241:Aspirin