After ACC/AHA and ESC Guidelines Pre-operative cardiological evaluation in non-cardiac surgery: certainties, controversial areas and opportunities for a team approach
A standardized and evidence-based approach to the cardiological management of patients undergoing noncardiac surgery has been recently defined by Task Forces of the American Heart Association (AHA), American College of Cardiology (ACC) and the European Society of Cardiology (ESC) that published thei...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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PAGEPress Publications
2015-12-01
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| Series: | Monaldi Archives for Chest Disease |
| Subjects: | |
| Online Access: | https://www.monaldi-archives.org/index.php/macd/article/view/183 |
| _version_ | 1818837626479706112 |
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| author | Stefano Urbinati Pompilio Faggiano Furio Colivicchi Carmine Riccio Maurizio Giuseppe Abrignani Alberto Genovesi-Ebert Francesco Fattirolli Stefania De Feo Simona Gambetti Massimo Uguccioni |
| author_facet | Stefano Urbinati Pompilio Faggiano Furio Colivicchi Carmine Riccio Maurizio Giuseppe Abrignani Alberto Genovesi-Ebert Francesco Fattirolli Stefania De Feo Simona Gambetti Massimo Uguccioni |
| author_sort | Stefano Urbinati |
| collection | DOAJ |
| description | A standardized and evidence-based approach to the cardiological management of patients undergoing noncardiac surgery has been recently defined by Task Forces of the American Heart Association (AHA), American College of Cardiology (ACC) and the European Society of Cardiology (ESC) that published their guidelines in 2007 and 2009, respectively. Both the recommendations moved from risk indices to a practical, stepwise approach of the patient, which integrates clinical risk factors and test results with the estimated stress of the planned surgical procedure. In the present paper the main topics of the guidelines are discussed, and moreover, emphasis is placed on four controversial issues such as the use of prophylactic coronary revascularization in patients with myocardial ischemia, the perioperative management of patients with congestive heart failure, the routine use of betablockers and statins, and, finally, the management of antiplatelet therapies in patients with coronary stents. In addition to promoting an improvement of immediate perioperative care, the preoperative cardiological evaluation should be a challenge for identifying subjects with enhanced risk of cardiovascular events, who should be treated and monitored during a long-term follow-up. |
| first_indexed | 2024-12-19T03:25:30Z |
| format | Article |
| id | doaj.art-aa721f81aede460a8b07216eee86d803 |
| institution | Directory Open Access Journal |
| issn | 1122-0643 2532-5264 |
| language | English |
| last_indexed | 2024-12-19T03:25:30Z |
| publishDate | 2015-12-01 |
| publisher | PAGEPress Publications |
| record_format | Article |
| series | Monaldi Archives for Chest Disease |
| spelling | doaj.art-aa721f81aede460a8b07216eee86d8032022-12-21T20:37:38ZengPAGEPress PublicationsMonaldi Archives for Chest Disease1122-06432532-52642015-12-0176310.4081/monaldi.2011.183After ACC/AHA and ESC Guidelines Pre-operative cardiological evaluation in non-cardiac surgery: certainties, controversial areas and opportunities for a team approachStefano Urbinati0Pompilio Faggiano1Furio Colivicchi2Carmine Riccio3Maurizio Giuseppe Abrignani4Alberto Genovesi-Ebert5Francesco Fattirolli6Stefania De Feo7Simona Gambetti8Massimo Uguccioni9UOC Cardiologia, Ospedale Bellaria, BolognaUOC Cardiologia, Ospedale Bellaria, BolognaUOC Cardiologia, Ospedale Bellaria, BolognaUOC Cardiologia, Ospedale Bellaria, BolognaUOC Cardiologia, Ospedale Bellaria, BolognaUOC Cardiologia, Ospedale Bellaria, BolognaUOC Cardiologia, Ospedale Bellaria, BolognaUOC Cardiologia, Ospedale Bellaria, BolognaUOC Cardiologia, Ospedale Bellaria, BolognaUOC Cardiologia, Ospedale Bellaria, BolognaA standardized and evidence-based approach to the cardiological management of patients undergoing noncardiac surgery has been recently defined by Task Forces of the American Heart Association (AHA), American College of Cardiology (ACC) and the European Society of Cardiology (ESC) that published their guidelines in 2007 and 2009, respectively. Both the recommendations moved from risk indices to a practical, stepwise approach of the patient, which integrates clinical risk factors and test results with the estimated stress of the planned surgical procedure. In the present paper the main topics of the guidelines are discussed, and moreover, emphasis is placed on four controversial issues such as the use of prophylactic coronary revascularization in patients with myocardial ischemia, the perioperative management of patients with congestive heart failure, the routine use of betablockers and statins, and, finally, the management of antiplatelet therapies in patients with coronary stents. In addition to promoting an improvement of immediate perioperative care, the preoperative cardiological evaluation should be a challenge for identifying subjects with enhanced risk of cardiovascular events, who should be treated and monitored during a long-term follow-up.https://www.monaldi-archives.org/index.php/macd/article/view/183noncardiac surgeryperioperative managementnonivasive testingpreoperative revascularizationbetablockersstatins |
| spellingShingle | Stefano Urbinati Pompilio Faggiano Furio Colivicchi Carmine Riccio Maurizio Giuseppe Abrignani Alberto Genovesi-Ebert Francesco Fattirolli Stefania De Feo Simona Gambetti Massimo Uguccioni After ACC/AHA and ESC Guidelines Pre-operative cardiological evaluation in non-cardiac surgery: certainties, controversial areas and opportunities for a team approach Monaldi Archives for Chest Disease noncardiac surgery perioperative management nonivasive testing preoperative revascularization betablockers statins |
| title | After ACC/AHA and ESC Guidelines Pre-operative cardiological evaluation in non-cardiac surgery: certainties, controversial areas and opportunities for a team approach |
| title_full | After ACC/AHA and ESC Guidelines Pre-operative cardiological evaluation in non-cardiac surgery: certainties, controversial areas and opportunities for a team approach |
| title_fullStr | After ACC/AHA and ESC Guidelines Pre-operative cardiological evaluation in non-cardiac surgery: certainties, controversial areas and opportunities for a team approach |
| title_full_unstemmed | After ACC/AHA and ESC Guidelines Pre-operative cardiological evaluation in non-cardiac surgery: certainties, controversial areas and opportunities for a team approach |
| title_short | After ACC/AHA and ESC Guidelines Pre-operative cardiological evaluation in non-cardiac surgery: certainties, controversial areas and opportunities for a team approach |
| title_sort | after acc aha and esc guidelines pre operative cardiological evaluation in non cardiac surgery certainties controversial areas and opportunities for a team approach |
| topic | noncardiac surgery perioperative management nonivasive testing preoperative revascularization betablockers statins |
| url | https://www.monaldi-archives.org/index.php/macd/article/view/183 |
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