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Guidelines for Assessing and Managing the Perioperative Risk from Coronary Artery Disease Associated with Major Noncardiac Surgery

[+] Article and Author Information

American College of Physicians* *This paper, written by Valerie A. Palda, MD, MSc, and Allan S. Detsky, MD, PhD, was developed for the Health and Public Policy Committee by the Clinical Efficacy Assessment Subcommittee: George E. Thibault, MD, Chair; John R. Feussner, MD, Co-Chair; Anne-Marie J. Audet, MD; Gottlieb C. Freisinger Jr., MD; Daniel L. Kent, MD; Keith I. Marton, MD; Valerie Anne Palda, MD; John J. Whyte, MD: and Preston L. Winters, MD. This paper was approved by the Board of Regents on 25 October 1996. Requests for Reprints: Valerie A. Palda, MD. 4-151, St. Michael's Hospital, 30 Bond Street, Toronto. Ontario M5B 1W8. Canada. Current Author Addresses: Dr. Palda: 4-151, St. Michael's Hospital, 30 Bond Street, Toronto, Ontario M5B 1W8, Canada.


Copyright ©2004 by the American College of Physicians


Ann Intern Med. 1997;127(4):309-312. doi:10.7326/0003-4819-127-4-199708150-00011
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The numbers in square brackets are cross-references to the numbered sections in the accompanying background paper, “Perioperative Assessment and Management of Risk from Coronary Artery Disease,” which is part II of this guideline (see pages 313-328).

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Appendix Figure 1. Suggested algorithm for the risk assessment and management of patients at low or intermediate risk for perioperative cardiac events, usually myocardial infarction and death. Boxed phrases indicate recommended actions. The italicized words beside the boxes indicate the level of evidence supporting the recommendation. If no italicized word is present, no evidence exists for or against use. DTI = dipyridamole thallium imaging; DSE = dobutamine stress echocardiography.
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Appendix Figure 2. Suggested algorithm for the management of patients at high risk for perioperative cardiac events. Boxed phrases indicate recommended actions. The italicized words below the boxes indicate the level of evidence supporting the recommendation. If no italicized word is present, no evidence exists for or against use. AHA = American Heart Association; CHF = congestive heart failure.
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