Cardiac Risk Stratification Among Ambulatory Patients Undergoing Non-Cardiac Surgery

被引：0
作者：
Kaw R. [1 ]
机构：
[1] M2 -113, Cleveland
来源：
Current Anesthesiology Reports | 2016年 / 6卷 / 4期
关键词：
Functional class; Non-cardiac surgery; Revised cardiac risk index; Risk stratification; Stress test;
D O I：
10.1007/s40140-016-0188-z
中图分类号：
学科分类号：
摘要：
Cardiovascular complications are the leading cause of death within 30 days after non-cardiac surgery. Accurate perioperative cardiac risk assessment can be difficult and involves use of clinical risk indices; non-invasive cardiac testing, and potential cardiac biomarker levels are on the horizon. The association of presence and or severity of perfusion defects on non-invasive cardiac testing to adverse postoperative cardiac outcome needs better than observational evidence. Guidelines supporting judicious and meaningful use of preoperative non-invasive cardiac testing exist, but these are not based on randomized controlled data. There is also a relative paucity of prospective randomized controlled data assessing the role of preoperative coronary revascularization, except for patients with three vessels or left main disease. On the other hand, recent randomized controlled trials suggest higher postoperative mortality among patients with asymptomatic elevation of cardiac troponins in the perioperative period that do not qualify as myocardial infarction. © 2016, Springer Science + Business Media New York.
引用
收藏
页码：394 / 401
页数：7
相关论文
共 48 条
  • [1] Weiser T.G., Haynes A.B., Molina G., Et al., Estimate of the volume of surgery in 2012: An assessment supporting improved health outcomes, Surgical Services: Access and Coverage
  • [2] Weiser T.G., Regenbogen S.E., Thompson K.D., Et al., An estimation of the global volume of surgery: a modeling strategy based on available data, Lancet, 372, pp. 139-144, (2008)
  • [3] Deveraux P.J., Yang H., Yusuf S., Et al., POISE study group. Effects of extended-release metoprolol succinate in patients undergoing non-cardiac surgery (POISE-trial): a randomized controlled trial, Lancet, 371, pp. 1839-1847, (2008)
  • [4] Landesberg G., Shatz V., Akopnik I., Et al., Association of cardiac troponin, CK-MB, and postoperative myocardial ischemia with long-term survival after major vascular surgery, J Am Coll Cardiol, 115, pp. 515-520, (2003)
  • [5] Deveraux P.J., Goldman L., Yusuf S., Et al., Surveillance and prevention of major perioperative ischemic cardiac events in patients undergoing non-cardiac surgery: a review, CMAJ, 173, pp. 779-788, (2005)
  • [6] Feringa H.H., Karagiannis S., Vidakovic R., Et al., Comparison of the incidence of cardiac arrhythmias, myocardial ischemia, and cardiac events in patients treated with endovascular versus open surgical repair of abdominal aortic aneurysms, Am J Cardiol, 100, pp. 1479-1484, (2007)
  • [7] Fleisher L.A., Fleischmann K.E., Auerbach A.D., Et al., ACC/AHA 2014 guideline on perioperative cardiovascular evaluation and management of patients undergoing non-cardiac surgery: a report of the American College of Cardiology/American Heart Association task force on practice guidelines, Circulation, 130, pp. e278-e333, (2014)
  • [8] Lee T.H., Marcantonio E.R., Mangione C.M., Et al., Derivation and prospective validation of a simple index for prediction of cardiac risk of major non-cardiac surgery, Circulation, 100, pp. 1043-1049, (1999)
  • [9] Boersma E., Kertai M.D., Schouten O., Et al., Perioperative cardiovascular mortality in non-cardiac surgery: validation of the lee cardiac risk index, Am J Med, 118, pp. 1134-1141, (2005)
  • [10] Ford M.K., Beattie W.S., Wijeysundera D.N., Et al., Systematic review: prediction of perioperative cardiac complications and mortality by the revised cardiac risk index, Ann Intern Med, 152, pp. 26-35, (2010)
12345