Actual Issues of the Cardiac Complications Risk Assessment and Correction in Non-Cardiac Surgery

Worldwide, more than 200 million non-cardiac surgeries are performed annually, and this number is constantly increasing; cardiac complications are the leading cause of death in such surgeries. So, in a multicenter study conducted in 27 countries, cardiovascular complications were present in 68% of c...

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Main Author: A. N. Sumin
Format: Article
Language:English
Published: Столичная издательская компания 2020-11-01
Series:Рациональная фармакотерапия в кардиологии
Subjects:
Online Access:https://www.rpcardio.online/jour/article/view/2295
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author A. N. Sumin
author_facet A. N. Sumin
author_sort A. N. Sumin
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description Worldwide, more than 200 million non-cardiac surgeries are performed annually, and this number is constantly increasing; cardiac complications are the leading cause of death in such surgeries. So, in a multicenter study conducted in 27 countries, cardiovascular complications were present in 68% of cases of death in the postoperative period. Registers of recent years have shown that the number of such complications remains high, for example, with a dynamic assessment of troponins, perioperative myocardial damage was detected in 13-18% of cases. This review provides a critical analysis of the step-by-step algorithm for assessing cardiac risk of non-cardiac operations considering the emergence of new publications on this topic. The review discusses new data on risk assessment scales, functional state assessment, the use of non-invasive tests, biomarkers, the role of preventive myocardial revascularization in the preoperative period, and drug therapy. The issues of non-cardiac operations after percutaneous coronary intervention, perioperative myocardial damage are considered separately. The review emphasizes the difficulties in obtaining evidence, conducting randomized clinical trials in this section of medicine, which do not allow obtaining unambiguous conclusions in most cases and lead to inconsistencies and ambiguities in the recommendations of various expert groups. This review will help practitioners navigate this issue and help to use the optimal diagnostic and treatment strategy before performing non-cardiac surgery.
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spelling doaj.art-e49559ba5e314b38a8586118390019fe2024-04-01T07:43:40ZengСтоличная издательская компанияРациональная фармакотерапия в кардиологии1819-64462225-36532020-11-0116574975810.20996/1819-6446-2020-10-081790Actual Issues of the Cardiac Complications Risk Assessment and Correction in Non-Cardiac SurgeryA. N. Sumin0Research Institute for Complex Issues of Cardiovascular DiseasesWorldwide, more than 200 million non-cardiac surgeries are performed annually, and this number is constantly increasing; cardiac complications are the leading cause of death in such surgeries. So, in a multicenter study conducted in 27 countries, cardiovascular complications were present in 68% of cases of death in the postoperative period. Registers of recent years have shown that the number of such complications remains high, for example, with a dynamic assessment of troponins, perioperative myocardial damage was detected in 13-18% of cases. This review provides a critical analysis of the step-by-step algorithm for assessing cardiac risk of non-cardiac operations considering the emergence of new publications on this topic. The review discusses new data on risk assessment scales, functional state assessment, the use of non-invasive tests, biomarkers, the role of preventive myocardial revascularization in the preoperative period, and drug therapy. The issues of non-cardiac operations after percutaneous coronary intervention, perioperative myocardial damage are considered separately. The review emphasizes the difficulties in obtaining evidence, conducting randomized clinical trials in this section of medicine, which do not allow obtaining unambiguous conclusions in most cases and lead to inconsistencies and ambiguities in the recommendations of various expert groups. This review will help practitioners navigate this issue and help to use the optimal diagnostic and treatment strategy before performing non-cardiac surgery.https://www.rpcardio.online/jour/article/view/2295cardiac complicationsrisk assessmentnon-cardiac surgery
spellingShingle A. N. Sumin
Actual Issues of the Cardiac Complications Risk Assessment and Correction in Non-Cardiac Surgery
Рациональная фармакотерапия в кардиологии
cardiac complications
risk assessment
non-cardiac surgery
title Actual Issues of the Cardiac Complications Risk Assessment and Correction in Non-Cardiac Surgery
title_full Actual Issues of the Cardiac Complications Risk Assessment and Correction in Non-Cardiac Surgery
title_fullStr Actual Issues of the Cardiac Complications Risk Assessment and Correction in Non-Cardiac Surgery
title_full_unstemmed Actual Issues of the Cardiac Complications Risk Assessment and Correction in Non-Cardiac Surgery
title_short Actual Issues of the Cardiac Complications Risk Assessment and Correction in Non-Cardiac Surgery
title_sort actual issues of the cardiac complications risk assessment and correction in non cardiac surgery
topic cardiac complications
risk assessment
non-cardiac surgery
url https://www.rpcardio.online/jour/article/view/2295
work_keys_str_mv AT ansumin actualissuesofthecardiaccomplicationsriskassessmentandcorrectioninnoncardiacsurgery