October 1, 2026Journal of the American College of Cardiology
2026 AHA/ACC/ACS/ASNC/HRS/SCA/SCCT/SCMR/SVM Guideline for Perioperative Cardiovascular Management for Noncardiac Surgery
Why the study?
The 2014 ACC/AHA guideline on perioperative cardiovascular evaluation and management of patients undergoing noncardiac surgery required updating with new evidence and management strategies.
Population
Adult patients undergoing noncardiac surgery
Comparison
Updated guideline recommendations vs 2014 guideline recommendations
Design
Comprehensive literature review and guideline update
Authors
Discussion
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Key expert perspectives
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“In assessing risk, we are encouraged to consider the procedure, the timing (urgent, time-sensitive, or elective), the patient's clinical status, the mode of anesthesia, and possible surgical modifications to the procedure that might mitigate risk. Stress testing and other preoperative evaluation is reserved for patients with poor or unknown functional capacity.”
“the recommendations, supportive text, figures, tables, and references are identical to those in the 2024 publication”
Overview
Adopt 2026 perioperative CV management strategies for noncardiac surgery; extends 2014 guideline with updated evidence synthesis.
Key Points
- Updated clinical recommendations provide standardized perioperative cardiovascular management for adult patients scheduled to undergo diverse noncardiac surgery procedures.
- Guideline synthesis incorporated comprehensive database searches across MEDLINE and EMBASE from August 2022 to March 2023 to evaluate cardiovascular disease interventions.
- These consolidated strategies supersede the 2014 guidance, guiding pharmacological therapies and perioperative monitoring to optimize safety throughout noncardiac surgery.
Structured PICO
P
Population
Adult patients undergoing noncardiac surgery requiring perioperative cardiovascular evaluation and management.
I
Intervention
Perioperative cardiovascular evaluation and management strategies, including pharmacological therapies, perioperative monitoring, and devices
This document provides the updated 2026 multi-society guidelines for perioperative cardiovascular evaluation and management of adults undergoing noncardiac surgery.
Cite This Study
Thompson et al. (2026) conducted a review in Perioperative cardiovascular management for noncardiac surgery. 2026 AHA/ACC/ACS/ASNC/HRS/SCA/SCCT/SCMR/SVM Guideline was evaluated. The 2026 AHA/ACC/ACS/ASNC/HRS/SCA/SCCT/SCMR/SVM Guideline provides updated evidence-based recommendations for perioperative cardiovascular evaluation and management in adults undergoing noncardiac surgery.