Document Detail

Reducing risk of cardiovascular events in noncardiac surgery.
MedLine Citation:
PMID:  16086638     Owner:  NLM     Status:  MEDLINE    
Cardiac adverse events are a major cause of complications in noncardiac surgery. The benefit of preventive coronary artery revascularisation in stable patients before noncardiac surgery has recently been clarified: in the short-term there is no reduction in the number of postoperative myocardial infarction, deaths or hospital length of stay. Coronary artery revascularisation should be limited to these patients who have a well-defined need for the procedure, independent of the need of noncardiac surgery. Optimising medical therapy remains the best option for reducing perioperative complications in stable patients: the addition of statin therapy in candidates for noncardiac surgery with known or strongly suspected coronary disease may be conceived. There is compelling evidence for the use of beta-blockers in reducing cardiac risk. This review presents the studies that support the beneficial effect of beta-blockers, pharmacological effects and some practical aspects in noncardiac surgery. In the management of most of these patients, the use of beta-blockers can aid in the avoidance of a preoperative stress test. The remaining problem to solve is the cost-effective identification of the small group of patients in which the protective effect of beta-blocker therapy is insufficient and a cardiac revascularisation should be considered.
Enrico Passamonti; Salvatore Pirelli
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Publication Detail:
Type:  Comparative Study; Journal Article; Review    
Journal Detail:
Title:  Expert opinion on pharmacotherapy     Volume:  6     ISSN:  1744-7666     ISO Abbreviation:  Expert Opin Pharmacother     Publication Date:  2005 Aug 
Date Detail:
Created Date:  2005-08-09     Completed Date:  2006-06-21     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  100897346     Medline TA:  Expert Opin Pharmacother     Country:  England    
Other Details:
Languages:  eng     Pagination:  1507-15     Citation Subset:  IM    
Division of Cardiology, Istituti Ospitalieri di Cremona, Vl Concordia 1, 26100 Cremona, Italy.
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MeSH Terms
Adrenergic beta-Antagonists / economics,  therapeutic use*
Cardiovascular Diseases / economics,  prevention & control*
Coronary Artery Bypass / economics
Cost-Benefit Analysis
Eligibility Determination
Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
Myocardial Infarction / economics,  prevention & control*
Perioperative Care / economics
Postoperative Complications / economics,  prevention & control*
Practice Guidelines as Topic
Randomized Controlled Trials as Topic
Risk Factors
Surgical Procedures, Operative* / adverse effects
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Hydroxymethylglutaryl-CoA Reductase Inhibitors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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