Preoperative cardiac risks in noncardiac surgery: The role of coronary angiography
The preoperativeÂ evaluation ofÂ patients candidatesÂ to noncardiacÂ surgery requires a knowledgeÂ ofÂ factorsÂ relatedÂ both toÂ type ofÂ surgery andÂ toÂ features of theÂ single patient, potentiallyÂ responsibleÂ forÂ perioperativeÂ cardiovascularÂ complications , fatal and nonfatal. The assessment ofÂ Â symptomsÂ and/or noninvasiveÂ testing indicating theÂ presence ofÂ coronaryÂ arteryÂ disease mayÂ suggest theÂ needÂ forÂ medical therapyÂ optimization and, eventually, coronaryÂ arteriographyÂ beforeÂ theÂ scheduled timingÂ of noncardiacÂ surgery. There isÂ no evidenceÂ favoringÂ a prophylacticÂ myocardial revascularization (percutaneous orÂ surgical) and moreÂ studies are needed toÂ defineÂ the role of coronary arteryÂ disease diagnosis and treatment beforeÂ high-risk nonÂ cardiacÂ surgery.
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