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Trends in Perioperative Cardiovascular Events

Trends in Perioperative Cardiovascular Events Research Original Investigation Cardiovascular and Cerebrovascular Events and Noncardiac Surgery Invited Commentary Mostly Sunny, With Showers Nicole M. Bhave, MD; Kim A. Eagle, MD The past decade and a half has witnessed a culture change it will be interesting to see if perioperative stroke rates de- in perioperative cardiovascular evaluation and management. cline in future studies. On the basis of landmark studies such as the Coronary Artery In an administrative data set like the National Inpatient Revascularization Project (CARP) and the PeriOperative Sample, there is no clinical narrative, or even a timeline, for ISchemic Evaluation (POISE) any given admission. Therefore, it was not possible for the trial, we have learned that authors to determine with certainty how many of the Related article page 181 practices such as routine pre- reported MACCE were truly perioperative events, despite the operative coronary angiogra- sensitivity analyses that were performed. Introduction of a phy and one-size-fits-all β-blockade are not beneficial (and, in new International Classification of Diseases, Ninth Revision the latter case, appear to be harmful). The most recent itera- (ICD-9) code for prior stroke or transient ischemic attack in tion of the American College of Cardiology/American Heart 2007 may have somehow increased recognition http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA Cardiology American Medical Association

Trends in Perioperative Cardiovascular Events

JAMA Cardiology , Volume 2 (2) – Feb 28, 2017

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Publisher
American Medical Association
Copyright
Copyright 2016 American Medical Association. All Rights Reserved.
ISSN
2380-6583
eISSN
2380-6591
DOI
10.1001/jamacardio.2016.4786
Publisher site
See Article on Publisher Site

Abstract

Research Original Investigation Cardiovascular and Cerebrovascular Events and Noncardiac Surgery Invited Commentary Mostly Sunny, With Showers Nicole M. Bhave, MD; Kim A. Eagle, MD The past decade and a half has witnessed a culture change it will be interesting to see if perioperative stroke rates de- in perioperative cardiovascular evaluation and management. cline in future studies. On the basis of landmark studies such as the Coronary Artery In an administrative data set like the National Inpatient Revascularization Project (CARP) and the PeriOperative Sample, there is no clinical narrative, or even a timeline, for ISchemic Evaluation (POISE) any given admission. Therefore, it was not possible for the trial, we have learned that authors to determine with certainty how many of the Related article page 181 practices such as routine pre- reported MACCE were truly perioperative events, despite the operative coronary angiogra- sensitivity analyses that were performed. Introduction of a phy and one-size-fits-all β-blockade are not beneficial (and, in new International Classification of Diseases, Ninth Revision the latter case, appear to be harmful). The most recent itera- (ICD-9) code for prior stroke or transient ischemic attack in tion of the American College of Cardiology/American Heart 2007 may have somehow increased recognition

Journal

JAMA CardiologyAmerican Medical Association

Published: Feb 28, 2017

References