Reducing Cardiac Risk in Noncardiac Surgery

“Avoid hypotension.” That recommendation has appeared at the end of many preoperative consultation notes for patients undergoing major noncardiac surgery. This not-so-helpful advice has reflected the state of the science of perioperative cardiac risk reduction. A great deal of research provides insight into how to identify patients at moderate and high risk.14 Very little is known about strategies that might improve their outcomes.The era in which physicians can only guess at how to reduce a patient's risk of perioperative cardiac complications seems to be ending, however, as demonstrated by the study by Poldermans et al.5 in this issue . . .