REDUCING GLOBAL PERIOPERATIVE RISK
This resource center is jointly hosted by The American Journal of Medicine,
The American Journal of Cardiology, and the Canadian Journal of Cardiology.
key Findings
- Compared with the revised cardiac risk index alone, findings on preoperative CCTA appropriately improved risk estimation among patients who will experience perioperative cardiovascular death or a myocardial infarction (adjusted hazard ratio for extensive obstructive coronary artery disease, 3.76; 95% confidence interval [CI], 1.12 to 12.62).
- CCTA inappropriately resulted in overestimation of risk among patients who will not experience these outcomes within 30 days of non-cardiac surgery. With 30-day risk categories of <5%, 5-15%, and >15% for the primary outcome, the net absolute effect in a sample of 1000 patients was that CCTA would result in an inappropriate estimate of risk in 81 patients compared with risk estimation based on the revised cardiac risk index alone.
- While CCTA can improve risk estimation for patients who incur perioperative cardiovascular death or myocardial infarction, results are more than five times as likely to lead to an inappropriate overestimation of risk among those who will not experience these outcomes.
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