Annals for Hospitalists Inpatient Notes - Perioperative Medicine—The Past, Present, and Future of Cardiovascular Risk Assessment and Risk Reduction Strategies
Authors: Paul J. Grant, Kim A. Eagle
Journal: Annals of Internal Medicine (2018)

Web Exclusives20 February 2018Annals for Hospitalists Inpatient Notes - Perioperative Medicine—The Past, Present, and Future of Cardiovascular Risk Assessment and Risk Reduction StrategiesPaul J. Grant, MD and Kim A. Eagle, MDPaul J. Grant, MDUniversity of Michigan, Ann Arbor, Michigan (P.J.G., K.A.E.)Search for more papers by this author and Kim A. Eagle, MDUniversity of Michigan, Ann Arbor, Michigan (P.J.G., K.A.E.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M18-0109 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Perioperative medicine is an evolving field that has become increasingly collaborative. As surgical patients become older and their conditions more complex, surgeons routinely consult hospitalists for medical care. As the field of hospital medicine moves into its third decade, it is worthwhile to reflect on the evolution of cardiovascular risk stratification and risk reduction measures, and to look toward the future.Lessons From the PastAlthough the preoperative evaluation has always primarily focused on risk stratification and reduction, the science has continued to evolve. Early clinical risk prediction indices included the Goldman Multifactorial Cardiac Risk Index and the Detsky Cardiac ...References1. Eagle KA, Brundage BH, Chaitman BR, Ewy GA, Fleisher LA, Hertzer NR, et al. Guidelines for perioperative cardiovascular evaluation for noncardiac surgery. Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Committee on Perioperative Cardiovascular Evaluation for Noncardiac Surgery. Circulation. 1996;93:1278-317. [PMID: 8653858] MedlineGoogle Scholar2. Devereaux PJ, Yang H, Yusuf S, Guyatt G, Leslie K, Villar JC, et al; POISE Study Group. Effects of extended-release metoprolol succinate in patients undergoing non-cardiac surgery (POISE trial): a randomised controlled trial. Lancet. 2008;371:1839-47. [PMID: 18479744] doi:10.1016/S0140-6736(08)60601-7 CrossrefMedlineGoogle Scholar3. Douketis JD, Spyropoulos AC, Kaatz S, Becker RC, Caprini JA, Dunn AS, et al; BRIDGE Investigators. Perioperative bridging anticoagulation in patients with atrial fibrillation. N Engl J Med. 2015;373:823-33. [PMID: 26095867] doi:10.1056/NEJMoa1501035 CrossrefMedlineGoogle Scholar4. Fleisher LA, Fleischmann KE, Auerbach AD, Barnason SA, Beckman JA, Bozkurt B, et al; American College of Cardiology. 2014 ACC/AHA guideline on perioperative cardiovascular evaluation and management of patients undergoing noncardiac surgery: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines. J Am Coll Cardiol. 2014;64:e77-137. [PMID: 25091544] doi:10.1016/j.jacc.2014.07.944 CrossrefMedlineGoogle Scholar5. Duceppe E, Parlow J, MacDonald P, Lyons K, McMullen M, Srinathan S, et al. Canadian Cardiovascular Society guidelines on perioperative cardiac risk assessment and management for patients who undergo noncardiac surgery. Can J Cardiol. 2017;33:17-32. [PMID: 27865641] doi:10.1016/j.cjca.2016.09.008 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: University of Michigan, Ann Arbor, Michigan (P.J.G., K.A.E.)Disclosures: The authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M18-0109.Requests for Single Reprints: Paul J. Grant, MD, Division of Hospital Medicine, University of Michigan, 1500 East Medical Center Drive, Ann Arbor, MI 48109; e-mail, [email protected]edu. Previousarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoAnnals for Hospitalists - 20 February 2018 David H. Wesorick and Vineet Chopra Metrics 20 February 2018Volume 168, Issue 4Page: HO2-HO3KeywordsAspirinForecastingHeartHemorrhageHospital medicineHospitalistsMyocardial infarctionPalliative careRisk assessmentsStroke ePublished: 20 February 2018 Issue Published: 20 February 2018 Copyright & PermissionsCopyright © 2018 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...