Preoperative Assessment of Patients with Known or Suspected Coronary Disease

Cardiovascular disease is the leading cause of death in the United States, Canada, Europe, and Japan. 1 , 2 Of the 27 million patients who undergo surgery in the United States each year, approximately 8 million have coronary artery disease or risk factors for cardiovascular disease; 1 million have perioperative cardiac complications, which result in approximately $20 billion in annual costs for in-hospital and long-term care. 3 Over the next several decades, furthermore, the effects of the aging of the population will exacerbate the problem; more than 37 million patients will undergo surgery each year in the United States, of whom 40 percent . . .