Guidelines on Perioperative Cardiovascular Evaluation
Authors: Allan S. Brett
Journal: Annals of Internal Medicine (2010)

Letters15 June 2010Guidelines on Perioperative Cardiovascular EvaluationAllan S. Brett, MDAllan S. Brett, MDFrom University of South Carolina School of Medicine, Columbia, SC 29203.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-152-12-201006150-00016 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Chopra and colleagues (1) discuss a need to limit preoperative stress testing, preoperative coronary revascularization, and perioperative β-blockade. They use the phrase “time to throttle back,” because a growing body of research—much of it published in the past decade—has shown that these interventions do not improve outcomes in most patients. The authors promote the 2007 American College of Cardiology/American Heart Association (ACC/AHA) guideline on perioperative cardiovascular care for noncardiac surgery as a cost-effective and evidence-based approach.What Chopra and colleagues do not mention is that several of them were authors of the 1996 and 2002 versions of ...References1. Chopra V, Flanders SA, Froehlich JB, Lau WC, Eagle KA. Perioperative practice: time to throttle back. Ann Intern Med. 2010;152:47-51. [PMID: 19949135] LinkGoogle Scholar2. Brett AS. Coronary assessment before noncardiac surgery: current strategies are flawed. Circulation. 2008;117:3145-51. [PMID: 18559714] CrossrefMedlineGoogle Scholar3. American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery). ACC/AHA 2007 guidelines on perioperative cardiovascular evaluation and care for noncardiac surgery: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery): developed in collaboration with the American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Rhythm Society, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, and Society for Vascular Surgery. Circulation. 2007;116:418-99. [PMID: 17901357] MedlineGoogle Scholar4. Tricoci P, Allen JM, Kramer JM, Califf RM, Smith SC. Scientific evidence underlying the ACC/AHA clinical practice guidelines. JAMA. 2009;301:831-41. [PMID: 19244190] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From University of South Carolina School of Medicine, Columbia, SC 29203.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoPerioperative Practice: Time to Throttle Back Vineet Chopra , Scott A. Flanders , James B. Froehlich , Wei C. Lau , and Kim A. Eagle Guidelines on Perioperative Cardiovascular Evaluation Vineet Chopra , James B. Froehlich , and Kim A. Eagle Metrics 15 June 2010Volume 152, Issue 12Page: 824KeywordsAlgorithmsCardiac surgeryConflicts of interestCoronary revascularizationPatientsThoracic surgery ePublished: 15 June 2010 Issue Published: 15 June 2010 Copyright & PermissionsCopyright © 2010 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...