"Avoid hypotension." That recommendation has appeared at theend of many preoperative consultation notes for patients undergoingmajor noncardiac surgery. This not-so-helpful advice has reflectedthe state of the science of perioperative cardiac risk reduction.A great deal of research provides insight into how to identifypatients at moderate and high risk.1,2,3,4 Very little is knownabout strategies that might improve their outcomes.
The era in which physicians can only guess at how to reducea patient's risk of perioperative cardiac complications seemsto be ending, however, as demonstrated by the study by Poldermanset al.5 in this issue of . . . [Full Text of this Article]
Adesanya, A. O., de Lemos, J. A., Greilich, N. B., Whitten, C. W.
(2006). Management of perioperative myocardial infarction in noncardiac surgical patients.. Chest
130: 584-596
[Abstract][Full Text]
Auerbach, A., Goldman, L.
(2006). Assessing and Reducing the Cardiac Risk of Noncardiac Surgery. Circulation
113: 1361-1376
[Full Text]
Devereaux, P J, Beattie, W S., Choi, P. T-L, Badner, N. H, Guyatt, G. H, Villar, J. C, Cina, C. S, Leslie, K., Jacka, M. J, Montori, V. M, Bhandari, M., Avezum, A., Cavalcanti, A. B, Giles, J. W, Schricker, T., Yang, H., Jakobsen, C.-J., Yusuf, S.
(2005). How strong is the evidence for the use of perioperative {beta} blockers in non-cardiac surgery? Systematic review and meta-analysis of randomised controlled trials. BMJ
331: 313-321
[Abstract][Full Text]
O'Neil-Callahan, K., Katsimaglis, G., Tepper, M. R., Ryan, J., Mosby, C., Ioannidis, J. P.A., Danias, P. G.
(2005). Statins decrease perioperative cardiac complications in patients undergoing noncardiac vascular surgery: The Statins for Risk Reduction in Surgery (StaRRS) study. J Am Coll Cardiol
45: 336-342
[Abstract][Full Text]
Grayburn, P. A., Hillis, L D.
(2003). Cardiac Events in Patients Undergoing Noncardiac Surgery: Shifting the Paradigm from Noninvasive Risk Stratification to Therapy. ANN INTERN MED
138: 506-511
[Abstract][Full Text]
Chassot, P.-G., Delabays, A., Spahn, D. R.
(2002). Preoperative evaluation of patients with, or at risk of, coronary artery disease undergoing non-cardiac surgery. Br J Anaesth
89: 747-759
[Abstract][Full Text]
Bhattacharyya, T., Iorio, R., Healy, W. L.
(2002). Rate of and Risk Factors for Acute Inpatient Mortality After Orthopaedic Surgery. JBJS
84: 562-572
[Abstract][Full Text]
Auerbach, A. D., Goldman, L.
(2002). {beta}-Blockers and Reduction of Cardiac Events in Noncardiac Surgery: Scientific Review. JAMA
287: 1435-1444
[Abstract][Full Text]
Auerbach, A. D., Goldman, L.
(2002). {beta}-Blockers and Reduction of Cardiac Events in Noncardiac Surgery: Clinical Applications. JAMA
287: 1445-1447
[Abstract][Full Text]
Zaugg, M., Schaub, M. C., Pasch, T., Spahn, D. R.
(2002). Modulation of {beta}-adrenergic receptor subtype activities in perioperative medicine: mechanisms and sites of action. Br J Anaesth
88: 101-123
[Abstract][Full Text]
Boersma, E., Poldermans, D., Bax, J. J., Steyerberg, E. W., Thomson, I. R., Banga, J. D., van de Ven, L. L. M., van Urk, H., Roelandt, J. R. T. C., for the DECREASE Study Group,
(2001). Predictors of Cardiac Events After Major Vascular Surgery: Role of Clinical Characteristics, Dobutamine Echocardiography, and {beta}-Blocker Therapy. JAMA
285: 1865-1873
[Abstract][Full Text]
Heesen, M., Kunz, D., Rossaint, R., Blomeke, B.
(2000). Real-Time PCR Assay with Fluorescent Hybridization Probes for Rapid Genotyping of the CD14 Promotor Polymorphism. Clin. Chem.
46: 1866-1867
[Full Text]
Feldman, T., Fusman, B., McKinsey, J. F., Litwack, R. S., Gilligan, D. M., DeGruttola, V., Poldermans, D., Boersma, E., Thomson, I. R., Lee, T. H.
(2000). Beta-Blockade for Patients Undergoing Vascular Surgery. NEJM
342: 1051-1053
[Full Text]
Doshi, S., Singh, B. N.
(2000). Reducing Perioperative Cardiac Risk in Noncardiac Surgery: A Time to Delineate Simpler Strategies?. J CARDIOVASC PHARMACOL THER
5: 69-75