Perioperative Cardiovascular Risk Assessment and Management for Noncardiac Surgery: A Review

IMPORTANCE: Perioperative cardiovascular complications occur in 3% of hospitalizations for noncardiac surgery in the US. This review summarizes evidence regarding cardiovascular risk assessment prior to noncardiac surgery. OBSERVATIONS: Preoperative cardiovascular risk assessment requires a focused...

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Veröffentlicht in:	JAMA : the journal of the American Medical Association 2020-07, Vol.324 (3), p.279-290
Hauptverfasser:	Smilowitz, Nathaniel R, Berger, Jeffrey S
Format:	Artikel
Sprache:	eng
Schlagworte:	Adrenergic beta-Antagonists - administration & dosage Adrenergic beta-Antagonists - adverse effects Adults Age Factors Aged Anesthesia Angiotensin-Converting Enzyme Inhibitors - adverse effects Angiotensin-Converting Enzyme Inhibitors - therapeutic use Anticoagulants - administration & dosage Anticoagulants - adverse effects Arteriosclerosis Aspirin Aspirin - administration & dosage Aspirin - adverse effects Atherosclerosis Biomarkers - blood Bleeding Calculators Cardiovascular diseases Cardiovascular Diseases - etiology Cerebral infarction Complications Coronary Angiography Coronary artery disease Echocardiography, Transesophageal Electrocardiography - methods Equivalence Fibrinolytic Agents - administration & dosage Fibrinolytic Agents - adverse effects Health risks Heart diseases Heart Failure - diagnosis Heart Valve Diseases - diagnosis Humans Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use Implants Ischemia Metabolism Metoprolol Middle Aged Mortality Myocardial infarction Myocardial Infarction - diagnosis Myocardial Infarction - etiology Myocardial Ischemia - diagnosis Myocardial Revascularization Patients Perioperative care Postoperative Complications - etiology Postoperative Complications - prevention & control Preoperative Care - methods Risk assessment Risk Assessment - methods Risk management Signs and symptoms Statins Stents Stents - adverse effects Stroke - chemically induced Surgery Surgical Procedures, Operative - adverse effects Time Factors United States - epidemiology
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Zusammenfassung:	IMPORTANCE: Perioperative cardiovascular complications occur in 3% of hospitalizations for noncardiac surgery in the US. This review summarizes evidence regarding cardiovascular risk assessment prior to noncardiac surgery. OBSERVATIONS: Preoperative cardiovascular risk assessment requires a focused history and physical examination to identify signs and symptoms of ischemic heart disease, heart failure, and severe valvular disease. Risk calculators, such as the Revised Cardiac Risk Index, identify individuals with low risk (
ISSN:	0098-7484 1538-3598
DOI:	10.1001/jama.2020.7840