Why the study?
Myocardial infarction is the leading cause of mortality during peripheral artery surgery, prompting review of cardiac event risk stratification using preoperative stress testing.
Does preoperative stress testing improve cardiac event risk stratification in patients prior to vascular surgery?
Does preoperative stress testing improve cardiac event risk stratification in patients prior to vascular surgery?
Preoperative stress testing prior to vascular surgery should be reserved for patients with elevated risk (functional capacity <4 METs) whose management would be altered by the results.
Reserve preoperative stress testing for select high-risk vascular patients if results alter management; leaves open its added value for risk stratification.
Myocardial infarction is the leading cause of mortality during peripheral artery surgery. The review summarizes the data on cardiac event risk stratification in angiosurgical patients by preoperative stress testing. The prognostic value of positive and negative results is described. Stress testing with physical activity or pharmacological agents is rarely indicated in patients at low risk of major adverse cardiovascular events. Stress testing may be used in patients at increased risk of myocardial infarction (functional activity less than <4 metabolic equivalents), and if the test results should change the approaches to perioperative therapy, anesthesia or the volume of surgical intervention and, in rare situations, to perform coronary revascularization.
No takes yet. Share an insight, caveat, or question.
Терешина et al. (2021) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: