Cardiovascular risk management in the peri-operative setting.
Acute coronary syndrome
General surgery
Perioperative care
Journal
The Medical journal of Australia
ISSN: 1326-5377
Titre abrégé: Med J Aust
Pays: Australia
ID NLM: 0400714
Informations de publication
Date de publication:
03 07 2023
03 07 2023
Historique:
revised:
17
03
2023
received:
29
11
2022
accepted:
27
03
2023
medline:
29
6
2023
pubmed:
11
6
2023
entrez:
11
6
2023
Statut:
ppublish
Résumé
Peri-operative cardiovascular events occur in up to 3% of patients undergoing non-cardiac surgery. Accurate cardiovascular risk assessment is important in the peri-operative setting, as it allows informed and shared decisions regarding the appropriateness of proceeding with surgery, guides surgical and anaesthetic approaches, and may influence the use of preventive medications and post-operative cardiac monitoring. Quantitative risk assessment may also inform a reconsideration of choosing a more limited lower risk type of surgery, or conservative management. Pre-operative cardiovascular risk assessment starts with clinical assessment and should include an estimate of functional capacity. Specialised cardiac investigations are rarely indicated specifically to assess pre-operative cardiovascular risk. The decision regarding cardiac investigations is influenced by the nature, extent and urgency of surgery. The strategy of performing pre-operative revascularisation to improve post-operative outcomes is not evidence-based and recent international guidelines recommend against this.
Types de publication
Journal Article
Review
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
30-39Informations de copyright
© 2023 The Authors. Medical Journal of Australia published by John Wiley & Sons Australia, Ltd on behalf of AMPCo Pty Ltd.
Références
Australian Institute of Health and Welfare: Hospitals at a glance 2017-18 [Cat. No. HSE 232]. AIHW, 2019. https://www.aihw.gov.au/reports/hospitals/hospitals-at-a-glance-2017-18 (viewed Feb 2023).
Puelacher C, Lurati Buse G, Seeberger D, et al. Perioperative myocardial injury after noncardiac surgery: incidence, mortality, and characterization. Circulation 2018; 137: 1221-1232.
Smilowitz NR, Gupta N, Ramakrishna H, et al. Perioperative major adverse cardiovascular and cerebrovascular events associated with noncardiac surgery. JAMA Cardiol 2017; 2: 181-187.
Sazgary L, Puelacher C, Lurati Buse G, et al. Incidence of major adverse cardiac events following non-cardiac surgery. Eur Heart J Acute Cardiovasc Care 2020; 10: 550-558.
Writing Committee for the VISION Study Investigators; Devereaux PJ, Biccard BM, Sigamani A, et al. Association of postoperative high-sensitivity troponin levels with myocardial injury and 30-day mortality among patients undergoing noncardiac surgery. JAMA 2017; 317: 1642-1651.
Duceppe E, Parlow J, MacDonald P, 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.
Fleisher LA, Fleischmann KE, Auerbach AD, et al. 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-e137.
Halvorsen S, Mehilli J, Cassese S, Hall TS, Abdelhamid M, Barbato E, et al. 2022 ESC Guidelines on cardiovascular assessment and management of patients undergoing non-cardiac surgery: Developed by the task force for cardiovascular assessment and management of patients undergoing non-cardiac surgery of the European Society of Cardiology (ESC) Endorsed by the European Society of Anaesthesiology and Intensive Care (ESAIC). Eur Heart J 2022; 43: 3826-3924.
Devereaux PJ, Mrkobrada M, Sessler DI, et al. Aspirin in patients undergoing noncardiac surgery. N Engl J Med 2014; 370: 1494-1503.
Smilowitz NR, Berger JS. Perioperative cardiovascular risk assessment and management for noncardiac surgery: a review. JAMA 2020; 324: 279-290.
Mullen MG, Michaels AD, Mehaffey JH, et al. Risk associated with complications and mortality after urgent surgery vs elective and emergency surgery: implications for defining “quality” and reporting outcomes for urgent surgery. JAMA Surg 2017; 152: 768-774.
Devereaux PJ, Sessler DI. Cardiac complications in patients undergoing major noncardiac surgery. N Engl J Med 2015; 373: 2258-2269.
Van Diepen S, Bakal JA, McAlister FA, Ezekowitz JA. Mortality and readmission of patients with heart failure, atrial fibrillation, or coronary artery disease undergoing noncardiac surgery: an analysis of 38 047 patients. Circulation 2011; 124: 289-296.
Lee TH, Marcantonio ER, Mangione CM, et al. Derivation and prospective validation of a simple index for prediction of cardiac risk of major noncardiac surgery. Circulation 1999; 100: 1043-1049.
Kumar R, McKinney WP, Raj G, et al. Adverse cardiac events after surgery: assessing risk in a veteran population. J Gen Intern Med 2001; 16: 507-518.
Soucy-Giguere M, Duceppe E, Shi S, et al. Correlation between preoperative electrocardiogram findings and NT-ProBNP and postoperative cardiac events after noncardiac surgery. Canadian Journal of Cardiology 2021; 37 (Suppl): S105-S106.
Studzińska D, Polok K, Rewerska B, et al. Prognostic value of preoperative electrocardiography in predicting myocardial injury after vascular surgery. Kardiol Pol 2022; doi: https://doi.org/10.33963/KP.a2022.0085 [Epub ahead of print].
Sapra R, Hallqvist L, Schlegel TT, et al. Predicting peri-operative troponin elevation by advanced electrocardiography. J Electrocardiol 2021; 68: 1-5.
Reilly DF, McNeely MJ, Doerner D, et al. Self-reported exercise tolerance and the risk of serious perioperative complications. Arch Intern Med 1999; 159: 2185-2192.
Levett D, Jack S, Swart M, et al. Perioperative cardiopulmonary exercise testing (CPET): consensus clinical guidelines on indications, organization, conduct, and physiological interpretation. Br J Anaesth 2018; 120: 484-500.
Lurati Buse GAL, Puelacher C, Gualandro DM, et al. Association between self-reported functional capacity and major adverse cardiac events in patients at elevated risk undergoing noncardiac surgery: a prospective diagnostic cohort study. Br J Anaesth 2021; 126: 102-110.
Marsman M, van Waes JAR, Grobben RB, et al. Added value of subjective assessed functional capacity before non-cardiac surgery in predicting postoperative myocardial injury. Eur J Prev Cardiol 2020; 28: 262-269.
Wotton R, Marshall A, Kerr A, et al. Does the revised cardiac risk index predict cardiac complications following elective lung resection? J Cardiothorac Surg 2013; 8: 220.
Hlatky MA, Boineau RE, Higginbotham MB, et al. A brief self-administered questionnaire to determine functional capacity (the Duke Activity Status Index). Am J Cardiol 1989; 64: 651-654.
Wijeysundera DN, Beattie WS, Hillis GS, et al. Integration of the Duke Activity Status Index into preoperative risk evaluation: a multicentre prospective cohort study. Br J Anaesth 2020; 124: 261-270.
Davies SJ, Minto G. Occam's razor at the sharp end: simplified preoperative risk assessment. Br J Anaesth 2021; 126: 27-30.
Riedel B, Li MH, Lee CHA, et al. A simplified (modified) Duke Activity Status Index (M-DASI) to characterise functional capacity: a secondary analysis of the Measurement of Exercise Tolerance before Surgery (METS) study. Br J Anaesth 2021; 126: 181-190.
Furukawa H. Current clinical implications of frailty and sarcopenia in vascular surgery: a comprehensive review of the literature and consideration of perioperative management. Ann Vasc Dis 2022; 15: 165-174.
Narain AS, Kitto AZ, Braun B, et al. Does the ACS NSQIP surgical risk calculator accurately predict complications rates after anterior lumbar interbody fusion procedures? Spine (Phila Pa 1976) 2021; 46: E655-E662.
Ford MK, Beattie WS, Wijeysundera DN. Systematic review: prediction of perioperative cardiac complications and mortality by the revised cardiac risk index. Ann Intern Med 2010; 152: 26-35.
Bilimoria KY, Liu Y, Paruch JL, et al. Development and evaluation of the universal ACS NSQIP surgical risk calculator: a decision aid and informed consent tool for patients and surgeons. J Am Coll Surg 2013; 217: 833-842.
Yap MKC, Ang KF, Gonzales-Porciuncula LA, Esposo E. Validation of the American College of Surgeons Risk Calculator for preoperative risk stratification. Heart Asia 2018; 10: e010993.
Lone Z, Hall S, Terakawa T, et al. Accuracy of American College of Surgeons National Surgical Quality Improvement Program Universal Surgical Risk Calculator in Predicting Complications Following Robot-Assisted Radical Cystectomy at a National Comprehensive Cancer Center. J Endourol 2019; 33: 383-388.
van der Hulst HC, Dekker JWT, Bastiaannet E, et al. Validation of the ACS NSQIP surgical risk calculator in older patients with colorectal cancer undergoing elective surgery. J Geriatr Oncol 2022; 13: 788-795.
Daabiss M. American Society of Anaesthesiologists physical status classification. Indian J Anaesth 2011;55: 111-115.
Wolters U, Wolf T, Stützer H, Schröder T. ASA classification and perioperative variables as predictors of postoperative outcome. Br J Anaesth 1996; 77: 217-222.
Dakik HA, Chehab O, Eldirani M, et al. A new index for pre-operative cardiovascular evaluation. J Am Coll Cardiol 2019; 73: 3067-3078.
Dakik HA, Eldirani M, Kaspar C, et al. Prospective validation of the AUB-HAS2 cardiovascular risk index. Eur Heart J Qual Care Clin Outcomes 2022; 8: 96-97.
Dakik HA, Sbaity E, Msheik A, et al. AUB-HAS2 Cardiovascular Risk Index: performance in surgical subpopulations and comparison to the Revised Cardiac Risk Index. J Am Heart Assoc 2020; 9: e016228.
Koshy AN, Ha FJ, Gow PJ, et al. Computed tomographic coronary angiography in risk stratification prior to non-cardiac surgery: a systematic review and meta-analysis. Heart 2019; 105: 1335-1342.
Rohde LE, Polanczyk CA, Goldman L, et al. Usefulness of transthoracic echocardiography as a tool for risk stratification of patients undergoing major noncardiac surgery. Am J Cardiol 2001; 87: 505-509.
Flu WJ, van Kuijk JP, Hoeks SE, et al. Prognostic implications of asymptomatic left ventricular dysfunction in patients undergoing vascular surgery. Anesthesiology 2010; 112: 1316-1324.
Karthikeyan G, Moncur RA, Levine O, et al. Is a pre-operative brain natriuretic peptide or N-terminal pro-B-type natriuretic peptide measurement an independent predictor of adverse cardiovascular outcomes within 30 days of noncardiac surgery? A systematic review and meta-analysis of observational studies. J Am Coll Cardiol 2009; 54: 1599-1606.
Rodseth RN, Padayachee L, Biccard BM. A meta-analysis of the utility of pre-operative brain natriuretic peptide in predicting early and intermediate-term mortality and major adverse cardiac events in vascular surgical patients. Anaesthesia 2008; 63: 1226-1233.
Rodseth RN, Biccard BM, Le Manach Y, et al. The prognostic value of pre-operative and post-operative B-type natriuretic peptides in patients undergoing noncardiac surgery: B-type natriuretic peptide and n-terminal fragment of pro-B-type natriuretic peptide: a systematic review and individual patient data meta-analysis. J Am Coll Cardiol 2014; 63: 170-180.
Vernooij LM, van Klei WA, Moons KG, et al. The comparative and added prognostic value of biomarkers to the Revised Cardiac Risk Index for preoperative prediction of major adverse cardiac events and all-cause mortality in patients who undergo noncardiac surgery. Cochrane Database Syst Rev 2021; (12): CD013139.
Clerico A, Zaninotto M, Aimo A, et al. Evaluation of the cardiovascular risk in patients undergoing major non-cardiac surgery: role of cardiac-specific biomarkers. Clin Chem Lab Med 2022; 60: 1525-1542.
Weber M, Luchner A, Seeberger M, et al. Incremental value of high-sensitive troponin T in addition to the revised cardiac index for peri-operative risk stratification in non-cardiac surgery. Eur Heart J 2013; 34: 853-862.
Humble CAS, Huang S, Jammer I, et al. Prognostic performance of preoperative cardiac troponin and perioperative changes in cardiac troponin for the prediction of major adverse cardiac events and mortality in noncardiac surgery: A systematic review and meta-analysis. PLoS One 2019; 14: e0215094.
Chew DP, Scott IA, Cullen L, et al. National Heart Foundation of Australia and Cardiac Society of Australia and New Zealand: Australian clinical guidelines for the management of acute coronary syndromes 2016. Med J Aust 2016; 205: 128-133. https://www.mja.com.au/journal/2016/205/3/national-heart-foundation-australia-and-cardiac-society-australia-and-new
Hwang JW, Kim EK, Yang JH, et al. Assessment of perioperative cardiac risk of patients undergoing noncardiac surgery using coronary computed tomographic angiography. Circ Cardiovasc Imaging 2015; 8: e002582.
Richardt G, Abdelghani M, Allali A, et al. Polymer-free drug-coated vs. bare-metal coronary stents in patients undergoing non-cardiac surgery: a subgroup analysis of the LEADERS FREE trial. Clin Res Cardiol 2021; 110: 162-171.
Shah S, Urtecho M, Firwana M, et al. Perioperative management of antiplatelet therapy: a systematic review and meta-analysis. Mayo Clin Proc Innov Qual Outcomes 2022; 6: 564-573.
Devereaux PJ, Mrkobrada M, Sessler DI, et al. Aspirin in patients undergoing noncardiac surgery. N Engl J Med 2014; 370: 1494-1503.
Guyatt GH, Oxman AD, Kunz R, et al. GRADE guidelines 6. Rating the quality of evidence - imprecision. J Clin Epidemiol 2011; 64: 1283-1293.
Rahman M, Donnangelo LL, Neal D, et al. Effects of perioperative acetyl salicylic acid on clinical outcomes in patients undergoing craniotomy for brain tumor. World Neurosurg 2015; 84: 41-47.
Oscarsson A, Gupta A, Fredrikson M, et al. To continue or discontinue aspirin in the perioperative period: a randomized, controlled clinical trial. Br J Anaesth 2010; 104: 305-312.
O'Brien J, Duncan H, Kirsh G, et al. Prevention of pulmonary embolism and deep vein thrombosis with low dose aspirin: Pulmonary Embolism Prevention (PEP) trial. Lancet 2000; 355: 1295-1302.
Zeng L, Brignardello-Petersen R, Hultcrantz M, et al. GRADE guidelines 32: GRADE offers guidance on choosing targets of GRADE certainty of evidence ratings. J Clin Epidemiol 2021; 137: 163-175.
Hawn MT, Graham LA, Richman JS, et al. Risk of major adverse cardiac events following noncardiac surgery in patients with coronary stents. JAMA 2013; 310: 1462-1472.
Dargham BB, Baskar A, Tejani I, et al. Intravenous antiplatelet therapy bridging in patients undergoing cardiac or non-cardiac surgery following percutaneous coronary intervention. Cardiovasc Revasc Med 2019; 20: 805-811.
Valgimigli M, Bueno H, Byrne RA, et al. 2017 ESC focused update on dual antiplatelet therapy in coronary artery disease developed in collaboration with EACTS: the Task Force for dual antiplatelet therapy in coronary artery disease of the European Society of Cardiology (ESC) and of the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J 2018; 39: 213-260.
Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS), European Association for Percutaneous Cardiovascular Interventions (EAPCI); Wijns W, Kolh P, Danchin N, et al. Guidelines on myocardial revascularization. Eur Heart J 2010; 31: 2501-2555.
London MJ, Schwartz GG, Hur K, Henderson WG. Association of perioperative statin use with mortality and morbidity after major noncardiac surgery. JAMA Intern Med 2017; 177: 231-242.
Lindenauer PK, Pekow P, Wang K, et al. Lipid-lowering therapy and in-hospital mortality following major noncardiac surgery. JAMA 2004; 291: 2092-2099.
McNally MM, Agle SC, Parker FM, et al. Preoperative statin therapy is associated with improved outcomes and resource utilization in patients undergoing aortic aneurysm repair. J Vasc Surg 2010; 51: 1390-1396.
Verzini F, De Rango P, Parlani G, et al. Effects of statins on early and late results of carotid stenting. J Vasc Surg 2011; 53: 71-9; discussion 9.
Le Manach Y, Godet G, Coriat P, et al. The impact of postoperative discontinuation or continuation of chronic statin therapy on cardiac outcome after major vascular surgery. Anesth Analg 2007; 104: 1326-1333.
Putzu A, Capelli B, Belletti A, et al. Perioperative statin therapy in cardiac surgery: a meta-analysis of randomized controlled trials. Crit Care 2016; 20: 395.
Ma B, Sun J, Diao S, Zheng B, Li H. Effects of perioperative statins on patient outcomes after noncardiac surgery: a meta-analysis. Ann Med 2018; 50: 402-409.
POISE Study Group; Devereaux PJ, 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: 1839-1847.
Shammash JB, Trost JC, Gold JM, et al. Perioperative beta-blocker withdrawal and mortality in vascular surgical patients. Am Heart J 2001; 141: 148-153.
London MJ, Hur K, Schwartz GG, Henderson WG. Association of perioperative β-blockade with mortality and cardiovascular morbidity following major noncardiac surgery. JAMA 2013; 309: 1704-1713.
Angeli F, Verdecchia P, Karthikeyan G, et al. ß-Blockers reduce mortality in patients undergoing high-risk non-cardiac surgery. Am J Cardiovasc Drugs 2010; 10: 247-259.
Bertrand M, Godet G, Meersschaert K, et al. Should the angiotensin II antagonists be discontinued before surgery? Anesth Analg 2001; 92: 26-30.
Coriat P, Richer C, Douraki T, et al. Influence of chronic angiotensin-converting enzyme inhibition on anesthetic induction. Anesthesiology 1994; 81: 299-307.
Schirmer U, Schürmann W. [Preoperative administration of angiotensin-converting enzyme inhibitors] [German]. Anaesthesist 2007; 56: 557-561.
Devereaux PJ, Sessler DI, Leslie K, et al. Clonidine in patients undergoing noncardiac surgery. N Engl J Med 2014; 370: 1504-1513.
Roshanov PS, Rochwerg B, Patel A, et al. Withholding versus continuing angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers before noncardiac surgery: an analysis of the vascular events in noncardiac surgery patients cohort evaluation prospective cohort. Anesthesiology 2017; 126: 16-27.
Skinner DL, Goga S, Rodseth RN, Biccard BM. A meta-analysis of intraoperative factors associated with postoperative cardiac complications. South Afr J Anaesth Analg 2012; 18: 186-191.
Marcucci M, Painter TW, Conen D, et al. Hypotension-avoidance versus hypertension-avoidance strategies in noncardiac surgery: an international randomized controlled trial. Ann Intern Med 2023; doi: https://doi.org/10.7326/M22-3157 [Epub ahead of print].
Wesselink EM, Kappen TH, Torn HM, et al. Intraoperative hypotension and the risk of postoperative adverse outcomes: a systematic review. Br J Anaesth 2018; 121: 706-721.
Marcucci M, Painter TW, Conen D, et al. Rationale and design of the PeriOperative ISchemic Evaluation-3 (POISE-3): a randomized controlled trial evaluating tranexamic acid and a strategy to minimize hypotension in noncardiac surgery. Trials 2022; 23: 101.
Devereaux PJ, Marcucci M, Painter TW, et al; POISE-3 Investigators. Tranexamic acid in patients undergoing noncardiac surgery. N Engl J Med 2022; 386:1986-1997.
Boukili IE, Flaris AN, Mercier F, et al. Prehabilitation before major abdominal surgery: Evaluation of the impact of a perioperative clinical pathway, a pilot study. Scand J Surg 2022; 111: 14574969221083394.
Fulop A, Lakatos L, Susztak N, et al. The effect of trimodal prehabilitation on the physical and psychological health of patients undergoing colorectal surgery: a randomised clinical trial. Anaesthesia 2021; 76: 82-90.
Blackwell JEM, Doleman B, Boereboom CL, et al. High-intensity interval training produces a significant improvement in fitness in less than 31 days before surgery for urological cancer: a randomised control trial. Prostate Cancer Prostatic Dis 2020; 23: 696-704.
Theadom A, Cropley M. Effects of preoperative smoking cessation on the incidence and risk of intraoperative and postoperative complications in adult smokers: a systematic review. Tob Control 2006; 15: 352-358.
Devereaux PJ, Xavier D, Pogue J, et al. Characteristics and short-term prognosis of perioperative myocardial infarction in patients undergoing noncardiac surgery: a cohort study. Ann Intern Med 2011; 154: 523-528.
Turan A, Leung S, Bajracharya GR, et al. Acute postoperative pain is associated with myocardial injury after noncardiac surgery. Anesth Analg 2020; 131: 822-829.
Botto F, Alonso-Coello P, Chan MT, et al. Myocardial injury after noncardiac surgery: a large, international, prospective cohort study establishing diagnostic criteria, characteristics, predictors, and 30-day outcomes. Anesthesiology 2014; 120: 564-578.
Eikelboom JW, Connolly SJ, Bosch J, et al. Rivaroxaban with or without aspirin in stable cardiovascular disease. N Engl J Med 2017; 377: 1319-1330.
Foucrier A, Rodseth R, Aissaoui M, et al. The long-term impact of early cardiovascular therapy intensification for postoperative troponin elevation after major vascular surgery. Anesth Analg 2014; 119: 1053-1063.
Devereaux P, Duceppe E, Guyatt G, et al. Dabigatran in patients with myocardial injury after non-cardiac surgery (MANAGE): an international, randomised, placebo-controlled trial. Lancet 2018; 391: 2325-2334.