Reich DL

Language: English
References: 50
Page: 240-247
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Introduction

In the aging population, cardiac disease plays a major role as a risk factor among patients undergoing noncardiac surgery. More than one million patients with known coronary artery disease (CAD) will undergo noncardiac surgery in the United States on an annual basis. There are three million additional noncardiac surgical patients who have risk factors for CAD and approximately four million other patients who are greater than 65 years of age (who are at increased risk of cardiac morbidity). Annually, about 50,000 out of 25 million patients undergoing noncardiac surgery have perioperative myocardial infarction (MI) (0.2%). Patients with known CAD have a 1.1% perioperative incidence of MI in noncardiac surgery. The mortality following perioperative MI has been reported as 26-70%. Thus, it is important to identify those patients who have increased risk of perioperative cardiac morbidity and mortality in order to correct conditions that might positively alter outcome. It is controversial whether preoperative interventions, such as drug therapy or myocardial revascularization, will be beneficial.

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