Preoperative coronary artery disease risk stratification based on dipyridamole imaging and a simple three-step, three-segment model for patients undergoing noncardiac vascular surgery or major general surgery

Lette, Jean; Waters, David D.; Cerino, Michel; Picard, Michel; Champagne, Patrick; Lapointe, Jacques

doi:10.1016/0002-9149(92)90702-z

Cited by 93 publications

(36 citation statements)

References 12 publications

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“…In vascular patients with either transient ischemic dilatation, reversible defects in all 3 segments assessed by planar imaging, or at least one severe reversible defect, half had a perioperative infarction or cardiac death (27). Marshall et al (28) found the number of reversible thallium defects to be the only multivariate predictor of perioperative events in vascular patients.…”

Section: Evidence Of Severe Cadmentioning

confidence: 99%

Myocardial Perfusion Imaging for Preoperative Risk Stratification: TABLE 1

Weinstein¹,

Steingart²

2011

J Nucl Med

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Learning Objectives: On successful completion of this activity, participants should be able to (1) describe the role of myocardial perfusion imaging in preoperative risk assessment and (2) integrate current guidelines into the application of preoperative myocardial perfusion imaging.Financial Disclosure: The authors of this article have indicated no relevant relationships that could be perceived as a real or apparent conflict of interest. CME Credit: SNM is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to sponsor continuing education for physicians. SNM designates each JNM continuing education article for a maximum of 1.0 AMA PRA Category 1 Credit. Physicians should claim only credit commensurate with the extent of their participation in the activity.For CE credit, participants can access this activity through the SNM Web site (http://www.snm.org/ce_online) through May 2012.This review considers the changing nature of surgical risk assessment and the definition of risk; discusses the pathophysiology of perioperative myocardial infarction in relation to tests of coronary flow reserve; surveys the extensive literature on preoperative myocardial perfusion imaging (MPI) and outlines key trends; presents practical points on image interpretation; addresses the needs of special populations; compares MPI with other modalities; and integrates recommendations from practice guidelines on the effective use of MPI in the preoperative patient.

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Section: Evidence Of Severe Cadmentioning

confidence: 99%

Myocardial Perfusion Imaging for Preoperative Risk Stratification: TABLE 1

Weinstein¹,

Steingart²

2011

J Nucl Med

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“…2). [23][24][25][26][27][28][29][30][31][32][33][34] Thc pooled data for dipyridamole myocardial perfusion imaging reveal a positive and negative predictive value of 36 f: 1 1 % and 07 i 2%, respectively. The positive predictive value of a severe defect, defined as a multisegmental, reversible defect or a combination of fixed and reversible defect for cardiac events was 45 * 5% and is associated with an increased incidence of postoperative death and myocardial infarction.…”

Section: Stms -Myocardial Perfusion Imaging In Assessing Preoperativementioning

confidence: 94%

Preoperative strategies to assess cardiac risk before noncardiac surgery

Younis

Miller

Chaitman

1995

Clinical Cardiology

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Summary:The strategies recommended in the preoperative cardiac risk assessment prior to major vascular and nonvascular surgery are reviewed. The role of clinical evaluation, noninvasive stress testing (exercise test, stress myocardial perfusion imaging, stress echocardiography), and Holter monitoring during the preoperative evaluation are outlined and the value of intervention based on the use of each test is discussed. Recommended strategies to evaluate patients based on their clinical risk markers in addition to the results of the noninvasive risk assessment are presented.

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“…preoperative thallium scintigraphy [26][27][28][29][30][31] . In addition, the prevalence of cardiovascular disease increases with age and nearly one fourth of non-cardiac surgical procedures (major intra-abdominal, thoracic, vascular, and orthopaedic procedures) performed in subjects > 65 years have been associated with significant perioperative cardiovascular morbidity and mortality 32 .…”

Section: The Dimension Of the Problemmentioning

confidence: 99%

Perioperative myocardial infarction in non-cardiac surgery. Pathophysiology and clinical implications

2006

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Advances in surgical and anaesthetic techniques and an aging patient population have resulted in more complex procedures being performed in greater numbers of aged subjects and in patients with a high likelihood of significant cardiovascular disease. Nearly one fourth of non-cardiac surgical procedures (major intra-abdominal, thoracic, vascular, and orthopaedic procedures) performed in persons older than 65 years have been found to be associated with significant perioperative cardiovascular morbidity and mortality. During previous years the main attempt was to define strategies to accurately estimate perioperative cardiovascular risk based either on the characteristics of surgery and on patient characteristics. More recently preventive medical strategies have been proposed. Therefore, the physician has to be aware of the key elements useful to calculate the perioperative cardiovascular risk, and of the medical preventive treatment or further interventions to adopt in patients candidate to surgery.

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Preoperative coronary artery disease risk stratification based on dipyridamole imaging and a simple three-step, three-segment model for patients undergoing noncardiac vascular surgery or major general surgery

Cited by 93 publications

References 12 publications

Myocardial Perfusion Imaging for Preoperative Risk Stratification: TABLE 1

Myocardial Perfusion Imaging for Preoperative Risk Stratification: TABLE 1

Preoperative strategies to assess cardiac risk before noncardiac surgery

Perioperative myocardial infarction in non-cardiac surgery. Pathophysiology and clinical implications

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