March 10, 1994New England Journal of Medicine
Assessment of Perioperative Cardiac Risk
Key result
Major noncardiac surgery carries a 1 to 2% risk of perioperative myocardial infarction in patients over 40, increasing to 3 to 10% in patients with angina undergoing major vascular surgery.
Why the study?
How should perioperative cardiac risk be assessed in patients undergoing noncardiac surgery?
Population
Patients undergoing noncardiac surgery, including those over 40 years of age and those with cardiovascular…
Design
Review
Authors
Discussion
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Member takes
Implication
Metoprolol reduced perioperative MI but raised stroke and mortality; challenges routine beta-blocker use in noncardiac surgery.
Structured PICO
How should perioperative cardiac risk be assessed in patients undergoing noncardiac surgery?
P
Population
Patients undergoing noncardiac surgery, including those over 40 years of age and those with cardiovascular disease (e.g., well-controlled angina undergoing major vascular surgery).
E
Exposure
Preoperative noninvasive cardiac tests
O
Outcome
Perioperative myocardial infarction and death from cardiac causeshard clinical
Perioperative cardiac risk assessment is crucial as the risk of myocardial infarction increases significantly in patients with underlying cardiovascular disease undergoing major noncardiac surgery.
Cite This Study
Lee Goldman (1994) conducted a review in Perioperative cardiac risk. Preoperative noninvasive cardiac tests was evaluated. Major noncardiac surgery carries a 1 to 2% risk of perioperative myocardial infarction in patients over 40, increasing to 3 to 10% in patients with angina undergoing major vascular surgery.