Preoperative Assessment of the Cardiac Patient Undergoing ...

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Recommendations for Beta Beta-Blocker Beta Beta-Blocker Blocker CLASS IIa M Medical di l Therapy Th 1. Beta blockers are probably recommended for patients undergoing vascular surgery in whom preoperative assessment identifies CHD. CHD (B) 2. Beta blockers are probably recommended for patients in whom preoperative assessment for vascular surgery identifies high cardiac risk, as defined by the presence of more than one clinical risk factor. (B) 3. Beta blockers are probably recommended for patients in whom preoperative assessment identifies CHD or high cardiac risk, as defined by the presence of more than one clinical risk factor, who are undergoing intermediate-risk or vascular surgery. (B)
High g Dose β-Blockers Blockers given g indiscriminately the evening before or morning of surgery may cause as many events as they prevent!
Page 1 and 2: Preoperative Assessment of the Card
Page 3 and 4: Lecture Outline • Estimating Pati
Page 5 and 6: "Always Always make make things as
Page 7 and 8: Death . MI or Periop. 10% Clinical
Page 9 and 10: Mortality Data: Anaerobic Threshold
Page 11 and 12: Surgery g y - Specific Specific p R
Page 13 and 14: Adjusteed Mortallity (%) 12 8 4 0 O
Page 15 and 16: Cardiovascular Risk: Non Cardiac S
Page 17 and 18: Predictors of Death at 30 Days: Bar
Page 19 and 20: Questions: Who Needs Further NonInv
Page 21 and 22: NonCardiac Testing Prior to Vascula
Page 23 and 24: Preoperative Dobutamine E Echocardi
Page 25 and 26: Clinical Assessment Only 1081 patie
Page 28 and 29: Fatal Perioperative MI Coronary C C
Page 30 and 31: Peri Peri-operative operative p Man
Page 32 and 33: Perrcentage of o Patientts 40 30 20
Page 34 and 35: B-Blockers Blockers to to Lower Low
Page 36 and 37: Effect of Perioperative BB-Blockade
Page 38 and 39: “Evidence does not support the us
Page 40 and 41: *Average heart rate 72 bpm - BB vs.
Page 42 and 43: POISE Trial: Metoprolol vs. Placebo
Page 44 and 45: Negative Consequences of Sudden Dis
Page 48 and 49: How Do I Use Beta Blockers? • Met
Page 50 and 51: In-hospital Mortality after Non-Car
Page 52 and 53: Carddiac death or nonnfatal MII (%)
Page 54 and 55: Outcome: Primary End Point Log-rank
Page 56 and 57: Aspirin in CVD Antithrombotic Trial
Page 58 and 59: Influence of Prior CABG to Lower Ri
Page 60 and 61: What About Immediate Coronary Revas
Page 62 and 63: Death/MI after Non Cardiac Surgery
Page 64 and 65: DES and Non-cardiac Surgery: Erasmu
Page 66 and 67: CARP: Coronary Revascularization P
Page 68 and 69: CARP: Main Results Revasc. No Revas
Page 70 and 71: Long Term Survival in CARP (2 (2-5
Page 72 and 73: But should we we revascularize reva
Page 74 and 75: Cardiac Risk of Vascular Surgery DE
Page 76 and 77: Timing of Surgery Perioperative Gui
Page 78 and 79: Who Needs Coronary y Angiography? g
Page 80 and 81: Potential Approach pp 1. Stable Cli
Page 82 and 83: Perioperative p Pain Management g
Page 84 and 85: Post Operative Therapy and F Future
Page 86 and 87: Resource Use and Outcomes After Imp
Page 88 and 89: “Prediction Is Very Difficult, Es
Page 90: “M “Medicine di i is i an Art A

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