TY - JOUR
T1 - Rise and fall of preoperative coronary revascularization
AU - Raghunathan, Deepa
AU - Palaskas, Nicolas L.
AU - Yusuf, Syed Wamique
AU - Eagle, Kim A.
N1 - Publisher Copyright:
© 2020, © 2020 Informa UK Limited, trading as Taylor & Francis Group.
PY - 2020/5/3
Y1 - 2020/5/3
N2 - Introduction: About 234 million major surgical procedures are performed each year worldwide, of which >60 million surgeries are performed in the United States. Though postoperative major adverse cardiac complications are relatively low, patients with postoperative myocardial infarction have higher in-hospital mortality. Thus, comprehensive cardiac evaluations, and in some cases, elective coronary revascularizations, are performed prior to surgery with an intent to minimize these complications. In 2009, approximately 4% of all elective percutaneous coronary interventions were performed in preparation for noncardiac surgery. Areas covered: We discuss relevant articles from the last 50 years regarding elective preoperative coronary revascularization prior to noncardiac surgery. Expert opinion: In the early years there was an interest in preemptive revascularization to reduce postoperative cardiac events; however, subsequent studies in patients with stable coronary artery disease have mostly shown that a strategy of routine prophylactic coronary revascularization prior to noncardiac surgery does not reduce postoperative cardiac complications.
AB - Introduction: About 234 million major surgical procedures are performed each year worldwide, of which >60 million surgeries are performed in the United States. Though postoperative major adverse cardiac complications are relatively low, patients with postoperative myocardial infarction have higher in-hospital mortality. Thus, comprehensive cardiac evaluations, and in some cases, elective coronary revascularizations, are performed prior to surgery with an intent to minimize these complications. In 2009, approximately 4% of all elective percutaneous coronary interventions were performed in preparation for noncardiac surgery. Areas covered: We discuss relevant articles from the last 50 years regarding elective preoperative coronary revascularization prior to noncardiac surgery. Expert opinion: In the early years there was an interest in preemptive revascularization to reduce postoperative cardiac events; however, subsequent studies in patients with stable coronary artery disease have mostly shown that a strategy of routine prophylactic coronary revascularization prior to noncardiac surgery does not reduce postoperative cardiac complications.
KW - Cardiac risk assessment
KW - coronary artery disease
KW - noncardiac surgery
KW - preoperative cardiac evaluation
KW - prophylactic coronary revascularization
UR - http://www.scopus.com/inward/record.url?scp=85085344477&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85085344477&partnerID=8YFLogxK
U2 - 10.1080/14779072.2020.1757432
DO - 10.1080/14779072.2020.1757432
M3 - Review article
C2 - 32299259
AN - SCOPUS:85085344477
SN - 1477-9072
VL - 18
SP - 249
EP - 259
JO - Expert Review of Cardiovascular Therapy
JF - Expert Review of Cardiovascular Therapy
IS - 5
ER -