Pharmacological strategy of perioperative risk reduction Review article
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Published:
Sep 30, 2010
Keywords:
non-cardiac surgery, pre-operative cardiac risk assessment, perioperative cardiac management, beta-blockers, statins
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Abstract
It is known that adverse cardiac events after noncardiac operations are a major source of complications and lead to an increased mortality rate. Currently there is an emphasis on medical therapy in risk reduction strategy and there are clear recommendations for beta-blocker, statin, aspirin, and ACE-inhibitor use. In this article we present the most important pharmacological strategies to reduce the risk for adverse cardiac events and, based on new guidelines, current knowledge about effectiveness, safety and practical concerns, such as whom, how and when therapy should be prescribed.
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Chybowska, B., Braksator , W., & Kuch , M. (2010). Pharmacological strategy of perioperative risk reduction. Medycyna Faktow (J EBM), 3(3(8), 19-24. Retrieved from https://journalsmededu.pl/index.php/jebm/article/view/2573
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References
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2. Fleisher L., Beckman J., Brown K. et al.: 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). Circulation 2007; 116: e418-e499.
3. Devereaux P., Yang H., Yusuf S. et al.: Effects of extended-release metoprolol succinate in patients undergoing non-cardiac surgery (POISE trial): a randomised controlled trial. Lancet 2008; 371: 1839-47.
4. Dunkelgrun M., Boersma E., Schouten O. et al.: Bisoprolol and fluvastatin for the reduction of perioperative cardiac mortality and myocardial infarction in intermediate-risk patients undergoing noncardiovascular surgery: a randomized controlled trial (DECREASEIV). Ann. Surg. 2009; 249: 921-926.
5. Fleischmann E., Beckman J., Buller Ch. et al.: 2009 ACCF/AHA Focused Update on Perioperative Beta Blockade. A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines (2009 Writing Group to Review New Evidence and Update the 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery). J. Am. Coll. Cardiol. 2009; 54: 2102-2128.
6. Hindler K., Shaw A., Samuels J. et al.: Improved postoperative outcomes associated with preoperative statin therapy. Anesthesiology 2006; 105: 1260-1272.
7. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2008: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2008 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association of the ESC (HFA) and endorsed by the European Society of Intensive Care Medicine (ESICM). Eur. Heart J. 2008; 29: 2388-2442.
8. Burger W., Chemnitius J., Kneissl G., Rucker G.: Low-dose aspirin for secondary cardiovascular prevention – cardiovascular risks after its perioperative withdrawal versus bleeding risks with its continuation – review and meta-analysis. J. Intern. Med. 2005; 257: 399-414.
2. Fleisher L., Beckman J., Brown K. et al.: 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). Circulation 2007; 116: e418-e499.
3. Devereaux P., Yang H., Yusuf S. et al.: Effects of extended-release metoprolol succinate in patients undergoing non-cardiac surgery (POISE trial): a randomised controlled trial. Lancet 2008; 371: 1839-47.
4. Dunkelgrun M., Boersma E., Schouten O. et al.: Bisoprolol and fluvastatin for the reduction of perioperative cardiac mortality and myocardial infarction in intermediate-risk patients undergoing noncardiovascular surgery: a randomized controlled trial (DECREASEIV). Ann. Surg. 2009; 249: 921-926.
5. Fleischmann E., Beckman J., Buller Ch. et al.: 2009 ACCF/AHA Focused Update on Perioperative Beta Blockade. A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines (2009 Writing Group to Review New Evidence and Update the 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery). J. Am. Coll. Cardiol. 2009; 54: 2102-2128.
6. Hindler K., Shaw A., Samuels J. et al.: Improved postoperative outcomes associated with preoperative statin therapy. Anesthesiology 2006; 105: 1260-1272.
7. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2008: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2008 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association of the ESC (HFA) and endorsed by the European Society of Intensive Care Medicine (ESICM). Eur. Heart J. 2008; 29: 2388-2442.
8. Burger W., Chemnitius J., Kneissl G., Rucker G.: Low-dose aspirin for secondary cardiovascular prevention – cardiovascular risks after its perioperative withdrawal versus bleeding risks with its continuation – review and meta-analysis. J. Intern. Med. 2005; 257: 399-414.