Perioperative cardioprotection in diabetic and elderly patients remains challenging, with metformin showing potential benefits while remote ischemic preconditioning yields conflicting clinical results.
Perioperative cardioprotection in elderly and diabetic patients remains challenging, with statins currently supported for continuation, while other strategies like metformin and RIPC need further clinical validation.
With the increasing age of the general population, medical conditions necessitating a surgical intervention will increase. Concomitant with advanced age, the prevalence of type 2 diabetes mellitus will also increase. These patients have a two- to three-fold higher risk of occurrence of cardiovascular events and are at higher risk of perioperative myocardial ischemia. This review will discuss recent advances in the field of perioperative cardioprotection and focus specifically on strategies that have aimed to protect the diabetic and the aged myocardium. This review will not deal with potential putative cardioprotective effects of opioids and anesthetic agents, as this is a very broad area that would necessitate a dedicated overview.
Momeni et al. (Wed,) conducted a review in Perioperative myocardial ischemia in diabetes and aging. Perioperative cardioprotection strategies (metformin, RIPC, beta-blockers, statins) was evaluated. Perioperative cardioprotection in diabetic and elderly patients remains challenging, with metformin showing potential benefits while remote ischemic preconditioning yields conflicting clinical results.