Utilization efficacy of noninvasive and invasive cardiac testing among stable cardiac patients undergoing noncardiac surgery

Cardiovascular Revascularization Medicine : Including Molecular Interventions
Constantine A HassapoyannesMohammad-Reza Movahed

Abstract

Patients with coronary artery disease are at increased risk from noncardiac surgery. We examined a population of cardiac patients undergoing noncardiac surgery to determine whether coronary angiography was successfully utilized to identify and treat ischemic heart disease. Our hypothesis was that cardiac complications would not differ between the group of patients who underwent coronary angiography and the group that did not. We conducted a secondary analysis from a prospective, cohort study of 314 patients with stable cardiac disease undergoing elective noncardiac surgery. The cohort was stratified by history of coronary arteriography. Follow-up extended postoperatively for a minimum of 30 days or until discharge if later. Of this cohort, 37.9% of the patients had a coronary angiogram at a median interval of 19 months (range, 1 day-13 years) before surgery. Among the 15 cardiac deaths (4.8%), 14 patients had compensated congestive heart failure and/or diabetes. The two arms were similar by surgical risk. Despite a higher clinical risk (P<.001), the catheterized vs. noncatheterized arm exhibited a similar cardiac morbidity and a lower cardiac mortality (0.8% vs. 7.2%, P=.01). The lower cardiac mortality persisted whether the pa...Continue Reading

References

Dec 28, 1995·The New England Journal of Medicine·D T Mangano, L Goldman
Jun 28, 1995·JAMA : the Journal of the American Medical Association·J J MasonM A Hlatky
Sep 15, 2001·Journal of General Internal Medicine·R KumarD D McIntire
Dec 26, 2001·Archives of Surgery·L Romero, C de Virgilio
Jan 5, 2002·The New England Journal of Medicine·L A Fleisher, K A Eagle
Aug 29, 2006·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·S E HoeksD Poldermans

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Citations

Apr 6, 2011·Cardiology in Review·Carlos E Sanchez, David R Richards
May 20, 2008·Clinical Cardiology·Eugene BraunwaldStephen Wiviott
Feb 27, 2010·Journal of Cardiovascular Medicine·Filippo BrandimarteMihai Gheorghiade
Mar 13, 2009·The Journal of Cardiovascular Nursing·Christopher S LeeBarbara Riegel
Feb 19, 2013·The Journal of Cardiovascular Nursing·Christopher S LeeCorrine Y Jurgens

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