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European Heart Journal Advance Access originally published online on October 4, 2005
European Heart Journal 2005 26(22):2358-2360; doi:10.1093/eurheartj/ehi510
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© The European Society of Cardiology 2005. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Should the ACC/AHA guidelines be changed in patients undergoing vascular surgery?

Sanne E. Hoeks1, Jeroen J. Bax2 and Don Poldermans1,*

1Department of Cardiology, Thoraxcenter Room H921, Erasmus MC, Dr Molewaterplein 40, 3015 GD Rotterdam, The Netherlands
2Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands

* Corresponding author. Tel: +31 10 4634613; fax: +31 10 4634957. E-mail address: d.poldermans@erasmusmc.nl

This editorial refers to ‘Vascular surgery patients: perioperative and long-term risk according to the ACC/AHA guidelines, the additive role of post-operative troponin evaluation’{dagger} by F. Bursi et al., on page 2448

The first 10% of the full text of this article appears below.

In western countries, annually about 4–10% of the population is scheduled for non-cardiac surgery. Patients undergoing vascular surgery are known to be at increased risk of peri-operative mortality and other cardiac complications due to underlying (a)-symptomatic coronary artery disease (CAD). Although the overall peri-operative event rate has declined over the past 30 years, 30-day cardiovascular mortality still remains as high as 3–5%.1 Myocardial infarction (MI) accounts for 10–40% of post-operative fatalities and can therefore be considered as the major determinant of peri-operative mortality associated with non-cardiac surgery.2

The pathophysiology of a peri-operative MI (PMI) is not entirely clear. However, similar to MIs occurring in the non-operative setting, coronary plaque rupture, leading to thrombus formation and subsequent vessel occlusion is suggested as an important causative mechanism.2 Surgery is an important . . . [Full Text of this Article]

Should the ACC/AHA guidelines be changed in patients undergoing vascular surgery?


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Related articles in EHJ:

Vascular surgery patients: perioperative and long-term risk according to the ACC/AHA guidelines, the additive role of post-operative troponin elevation
Francesca Bursi, Luciano Babuin, Andrea Barbieri, Luigi Politi, Mauro Zennaro, Teresa Grimaldi, Antonio Rumolo, Mauro Gargiulo, Andrea Stella, Maria Grazia Modena, and Allan S. Jaffe
EHJ 2005 26: 2448-2456. [Abstract] [Full Text]