American College of Cardiology/American Heart Association perioperative assessment guidelines for noncardiac surgery reduces cardiologic resource utilization preserving a favourable clinical outcome

Cinello, Margherita; Nucifora, Gaetano; Bertolissi, M; Badano, Luigi P.; Fresco, Claudio; Gonano, Nevio; Fioretti, P.

doi:10.2459/jcm.0b013e3280122d63

Cited by 12 publications

(9 citation statements)

References 45 publications

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“…They found that guidelines implementation reduced preoperative noninvasive diagnostic testing by 11% (P=0.01) and preserved a low rate of peri-operative cardiac complications. 7 Almanaseer 16124 | P a g e Out of 100 case records analyzed, we observed that anaesthesiologists had advised ECG in all patients (100%) before proceeding to surgery. ECG was not required in 13 patients (13%) as these patients were asymptomatic and they were to undergo low risk surgery.…”

Section: Discussionmentioning

confidence: 99%

“…They found that guidelines implementation reduced preoperative noninvasive diagnostic testing by 11% (P=0.01) and preserved a low rate of peri-operative cardiac complications. 7 Almanaseer 8 Hoeks S E conducted a survey to determine adherence to the ACC/AHA guidelines 2002 on peri-operative care in daily clinical practice. This survey showed poor agreement between ACC/AHA guideline recommendations and daily clinical practice.…”

Section: Discussionmentioning

confidence: 99%

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Adherence to acc/aha guidelines on pre-operative assessment of cardiac patients for non-cardiac surgery: an audit of 100 consecutive cases

Parekh¹,

Pandya²,

Mehta³

et al. 2017

Int J Recent Sci Res

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ARTICLE INFO ABSTRACTBackground and Aims: American College of Cardiology (ACC) and American Heart Association (AHA) have issued revised guidelines in 2007 for pre operative assessment of cardiac patients before non-cardiac surgery. We studied the pattern of practice for assessment of cardiac patients for non-cardiac surgery at our centre to find gap in existing practice from the ACC/AHA 2007 perioperative guidelines. Methods:We evaluated 100 consecutive case records of patients undergoing non-cardiac surgery referred to department of Medicine for preoperative assessment of cardiac problem. We analyzed clinical notes of anaesthesiologists and physicians to identify pattern of practice and analyze if the surgical team proceeded for surgery or physician requested further investigations like ECG, Echocardiography or TMT (Tread Mill Test) before proceeding to surgery. Results:We observed that emergency surgeries, active cardiac conditions and major cardiac risk factors were identified in all patients (100%) as per guidelines. All surgeries (100%) were not categorised according to risk. ECG was not necessary but advised in 13(13%) out of 100 patients and echocardiography was advised in 49 patients, out of which 40(81.6%) were not necessary. From the kappa statistic calculation, there was poor agreement between the guidelines and actual practice of advising Echocardiography (kappa value = 0.167). Conclusion:We found that there is significant gap in actual clinical practice and the recommendations of ACC/AHA 2007 guidelines on preoperative assessment of cardiac patients for non-cardiac surgery at our institute. We recommend development and application of guidelines on preoperative assessment of cardiac patients for non-cardiac surgery appropriate for our setting.

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Section: Discussionmentioning

confidence: 99%

“…They found that guidelines implementation reduced preoperative noninvasive diagnostic testing by 11% (P=0.01) and preserved a low rate of peri-operative cardiac complications. 7 Almanaseer 8 Hoeks S E conducted a survey to determine adherence to the ACC/AHA guidelines 2002 on peri-operative care in daily clinical practice. This survey showed poor agreement between ACC/AHA guideline recommendations and daily clinical practice.…”

Section: Discussionmentioning

confidence: 99%

Adherence to acc/aha guidelines on pre-operative assessment of cardiac patients for non-cardiac surgery: an audit of 100 consecutive cases

Parekh¹,

Pandya²,

Mehta³

et al. 2017

Int J Recent Sci Res

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“…Clinical data of all patients were recorded. All patients were in accordance with the diagnostic criteria for AMI by American College of Cardiology (ACC) or American Heart Association (AHA) : ( i ) chest pain lasting more than 30 min. ; ( ii ) the dynamic electrocardiogram change; ( iii ) levels of serum markers of myocardial injury were changed; ( iv ) the coronary angiography showed that patients could receive PCI for anatomy in infarct‐related artery.…”

Section: Methodsmentioning

confidence: 99%

Roles ofST2,IL‐33 andBNPin predicting major adverse cardiovascular events in acute myocardial infarction after percutaneous coronary intervention

Wang

Wang³

et al. 2017

J Cellular Molecular Medi

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This study investigated roles of serum ST2, IL‐33 and BNP in predicting major adverse cardiovascular events (MACEs) in acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI). Blood samples were collected from the included AMI patients (n = 180) who underwent PCI. All patients were divided into the MACEs and MACEs‐free groups. Enzyme‐linked immunosorbent assay was performed to measure serum levels of ST2, IL‐33 and BNP. Severity of coronary artery lesion was evaluated by Gensini score. Pearson correlation analysis was used. A receiver operating characteristics curve was drawn to evaluate the potential roles of ST2, IL‐33 and BNP in predicting MACEs, and Kaplan–Meier curve to analyse the 1‐year overall survival rate. Logistic regression analysis was conducted to analyse the independent risk factors for MACEs. Compared with the MACEs‐free group, the serum levels of ST2, IL‐33 and BNP were significantly higher in the MACEs group. Serum levels of ST2, IL‐33 and BNP were positively correlated with each other and positively correlated with Gensini score. The area under curves of ST2, IL‐33 and BNP, respectively, were 0.872, 0.675 and 0.902. The relative sensitivity and specificity were, respectively, 76.27% and 85.92%, 69.49% and 58.68%, as well as, 96.61% and 77.69%. Serum levels of ST2, IL‐33 and BNP were independent risk factors for MACEs. The 1‐year overall survival rate was higher in AMI patients with lower serum levels of ST2, IL‐33 and BNP. In conclusion, serum levels of ST2, IL‐33 and BNP have potential value in predicting MACEs in AMI patients undergoing PCI.

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“…4 Other studies have demonstrated that adherence to guidelines can reduce the incidence of inappropriate use of peri-operative cardiac testing without increasing the risk of peri-operative cardiac events. 5–7 The objective of this study is to examine the regional variation of PCST use in the Southern California Vascular Outcomes Improvement Collaborative (So Cal VOICe) and to investigate the possible drivers of that variation.…”

Section: Introductionmentioning

confidence: 99%

Preoperative Cardiac Stress Testing in the Southern California Vascular Outcomes Improvement Collaborative

Chan

Abou-Zamzam

Woo

2018

Annals of Vascular Surgery

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American College of Cardiology/American Heart Association perioperative assessment guidelines for noncardiac surgery reduces cardiologic resource utilization preserving a favourable clinical outcome

Abstract: Implementation of the ACC/AHA guidelines for cardiac risk assessment prior to noncardiac surgery in a consultant anaesthesiologist-led preoperative clinic reduced preoperative resources utilization, improved medical treatment and preserved a low rate of perioperative cardiac complications.

Cited by 12 publications

References 45 publications

Adherence to acc/aha guidelines on pre-operative assessment of cardiac patients for non-cardiac surgery: an audit of 100 consecutive cases

Adherence to acc/aha guidelines on pre-operative assessment of cardiac patients for non-cardiac surgery: an audit of 100 consecutive cases

Roles ofST2,IL‐33 andBNPin predicting major adverse cardiovascular events in acute myocardial infarction after percutaneous coronary intervention

Preoperative Cardiac Stress Testing in the Southern California Vascular Outcomes Improvement Collaborative

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