Skip to main content
Erschienen in: Der Kardiologe 5/2010

01.10.2010 | Leitlinien

Kommentar zu den „ESC Guidelines for Pre-Operative Cardiac Risk Assessment and Perioperative Cardiac Management in Non-Cardiac Surgery“

verfasst von: Prof. Dr. M. Kelm, H. Osterhues, M. Hennerici, M. Leschke, A. Osterspey, T. Lauer

Erschienen in: Die Kardiologie | Ausgabe 5/2010

Einloggen, um Zugang zu erhalten

Zusammenfassung

Die aktuelle Leitlinie der ESC stellt ein hilfreiches und im klinischen Alltag praktikables Instrument in der Risikostratifizierung von Patienten im Kontext eines geplanten operativen Eingriffes als auch im perioperativen Management dar. Besonders wertvoll erscheinen die klare Strukturierung der Risikostratifizierung von Patienten und geplantem operativem Eingriff in den 3 Risikokategorien niedrig, mittel und hoch und die sich daraus ableitenden Konsequenzen im medikamentösen als auch diagnostischen und interventionellen prä-, peri- und postoperativen Management. Der grundlegende Algorithmus und Entscheidungsbaum wird auch in den parallel zu diesem Kommentar publizierten Pocket-Leitlinien der Deutschen Gesellschaft für Kardiologie eine zentrale Stellung einnehmen.
Literatur
1.
Zurück zum Zitat http://www.prismant.nl/. Ziekenhuisstatistiek – Verrichtingen. 2008, Prismant http://www.prismant.nl/. Ziekenhuisstatistiek – Verrichtingen. 2008, Prismant
2.
Zurück zum Zitat Lee TH, Marcantonio ER, Mangione CM et al (1999) Derivation and prospective validation of a simple index for prediction of cardiac risk of major noncardiac surgery. Circulation 100:1043–1049PubMed Lee TH, Marcantonio ER, Mangione CM et al (1999) Derivation and prospective validation of a simple index for prediction of cardiac risk of major noncardiac surgery. Circulation 100:1043–1049PubMed
3.
Zurück zum Zitat Boersma E, Kertai MD, Schouten O et al (2005) Perioperative cardiovascular mortality in noncardiac surgery: validation of the Lee cardiac risk index. Am J Med 118:1134–1141CrossRefPubMed Boersma E, Kertai MD, Schouten O et al (2005) Perioperative cardiovascular mortality in noncardiac surgery: validation of the Lee cardiac risk index. Am J Med 118:1134–1141CrossRefPubMed
4.
Zurück zum Zitat Poldermans D, Bax JJ, Kertai MD et al (2003) Statins are associated with a reduced incidence of perioperative mortality in patients undergoing major noncardiac vascular surgery. Circulation 107:1848–1851CrossRefPubMed Poldermans D, Bax JJ, Kertai MD et al (2003) Statins are associated with a reduced incidence of perioperative mortality in patients undergoing major noncardiac vascular surgery. Circulation 107:1848–1851CrossRefPubMed
5.
Zurück zum Zitat Poldermans D, Bax JJ, Schouten O et al (2006) Should major vascular surgery be delayed because of preoperative cardiac testing in intermediate-risk patients receiving beta-blocker therapy with tight heart rate control? J Am Coll Cardiol 48:964–969CrossRefPubMed Poldermans D, Bax JJ, Schouten O et al (2006) Should major vascular surgery be delayed because of preoperative cardiac testing in intermediate-risk patients receiving beta-blocker therapy with tight heart rate control? J Am Coll Cardiol 48:964–969CrossRefPubMed
6.
Zurück zum Zitat Poldermans D, Boersma E, Bax JJ et al (1999) The effect of bisoprolol on perioperative mortality and myocardial infarction in high-risk patients undergoing vascular surgery. Dutch Echocardiographic Cardiac Risk Evaluation Applying Stress Echocardiography Study Group. N Engl J Med 341:1789–1794CrossRefPubMed Poldermans D, Boersma E, Bax JJ et al (1999) The effect of bisoprolol on perioperative mortality and myocardial infarction in high-risk patients undergoing vascular surgery. Dutch Echocardiographic Cardiac Risk Evaluation Applying Stress Echocardiography Study Group. N Engl J Med 341:1789–1794CrossRefPubMed
7.
Zurück zum Zitat Devereaux PJ, Yang H, Yusuf S et al (2008) Effects of extended-release metoprolol succinate in patients undergoing non-cardiac surgery (POISE trial): a randomised controlled trial. Lancet 371:1839–1847CrossRefPubMed Devereaux PJ, Yang H, Yusuf S et al (2008) Effects of extended-release metoprolol succinate in patients undergoing non-cardiac surgery (POISE trial): a randomised controlled trial. Lancet 371:1839–1847CrossRefPubMed
8.
Zurück zum Zitat Naughton C, Feneck RO (2007) The impact of age on 6-month survival in patients with cardiovascular risk factors undergoing elective non-cardiac surgery. Int J Clin Pract 61:768–776CrossRefPubMed Naughton C, Feneck RO (2007) The impact of age on 6-month survival in patients with cardiovascular risk factors undergoing elective non-cardiac surgery. Int J Clin Pract 61:768–776CrossRefPubMed
9.
Zurück zum Zitat Monaco M, Stassano P, Di Tommaso L et al (2009) Systematic strategy of prophylactic coronary angiography improves long-term outcome after major vascular surgery in medium- to high-risk patients: a prospective, randomized study. J Am Coll Cardiol 54(11):989–996CrossRefPubMed Monaco M, Stassano P, Di Tommaso L et al (2009) Systematic strategy of prophylactic coronary angiography improves long-term outcome after major vascular surgery in medium- to high-risk patients: a prospective, randomized study. J Am Coll Cardiol 54(11):989–996CrossRefPubMed
10.
Zurück zum Zitat Brady AR, Gibbs JS, Greenhalgh RM et al (2005) Perioperative betablockade (POBBLE) for patients undergoing infrarenal vascular surgery: results of a randomized double-blind controlled trial. J Vasc Surg 41:602–609CrossRefPubMed Brady AR, Gibbs JS, Greenhalgh RM et al (2005) Perioperative betablockade (POBBLE) for patients undergoing infrarenal vascular surgery: results of a randomized double-blind controlled trial. J Vasc Surg 41:602–609CrossRefPubMed
11.
Zurück zum Zitat Juul AB, Wetterslev J, Gluud C et al (2006) Effect of perioperative beta blockade in patients with diabetes undergoing major non-cardiac surgery: randomised placebo controlled, blinded multicentre trial. BMJ 332:1482CrossRefPubMed Juul AB, Wetterslev J, Gluud C et al (2006) Effect of perioperative beta blockade in patients with diabetes undergoing major non-cardiac surgery: randomised placebo controlled, blinded multicentre trial. BMJ 332:1482CrossRefPubMed
12.
Zurück zum Zitat Mangano DT, Layug EL, Wallace A, Tateo I (1996) Effect of atenolol on mortality and cardiovascular morbidity after noncardiac surgery. Multicenter Study of Perioperative Ischemia Research Group. N Engl J Med 335:1713–1720CrossRefPubMed Mangano DT, Layug EL, Wallace A, Tateo I (1996) Effect of atenolol on mortality and cardiovascular morbidity after noncardiac surgery. Multicenter Study of Perioperative Ischemia Research Group. N Engl J Med 335:1713–1720CrossRefPubMed
13.
Zurück zum Zitat Yang H, Raymer K, Butler R et al (2006) The effects of perioperative beta-blockade: results of the Metoprolol after Vascular Surgery (MaVS) study, a randomized controlled trial. Am Heart J 152:983–990CrossRefPubMed Yang H, Raymer K, Butler R et al (2006) The effects of perioperative beta-blockade: results of the Metoprolol after Vascular Surgery (MaVS) study, a randomized controlled trial. Am Heart J 152:983–990CrossRefPubMed
14.
Zurück zum Zitat Zaugg M, Bestmann L, Wacker J et al (2007) Adrenergic receptor genotype but not perioperative bisoprolol therapy may determine cardiovascular outcome in at-risk patients undergoing surgery with spinal block: the Swiss Beta Blocker in Spinal Anesthesia (BBSA) study: a double-blinded, placebo-controlled, multicenter trial with 1-year follow-up. Anesthesiology 107:33–44CrossRefPubMed Zaugg M, Bestmann L, Wacker J et al (2007) Adrenergic receptor genotype but not perioperative bisoprolol therapy may determine cardiovascular outcome in at-risk patients undergoing surgery with spinal block: the Swiss Beta Blocker in Spinal Anesthesia (BBSA) study: a double-blinded, placebo-controlled, multicenter trial with 1-year follow-up. Anesthesiology 107:33–44CrossRefPubMed
15.
Zurück zum Zitat Beattie WS, Wijeysundera DN, Karkouti K et al (2008) Does tight heart rate control improve beta-blocker efficacy? An updated analysis of the noncardiac surgical randomized trials. Anesth Analg 106:1039–1048CrossRefPubMed Beattie WS, Wijeysundera DN, Karkouti K et al (2008) Does tight heart rate control improve beta-blocker efficacy? An updated analysis of the noncardiac surgical randomized trials. Anesth Analg 106:1039–1048CrossRefPubMed
16.
Zurück zum Zitat Hindler K, Shaw AD, Samuels J et al (2006) Improved postoperative outcomes associated with preoperative statin therapy. Anesthesiology 105:1260–1272; quiz 1289–1290CrossRefPubMed Hindler K, Shaw AD, Samuels J et al (2006) Improved postoperative outcomes associated with preoperative statin therapy. Anesthesiology 105:1260–1272; quiz 1289–1290CrossRefPubMed
17.
18.
Zurück zum Zitat Schouten O, Hoeks SE, Welten GM et al (2007) Effect of statin withdrawal on frequency of cardiac events after vascular surgery. Am J Cardiol 100:316–320CrossRefPubMed Schouten O, Hoeks SE, Welten GM et al (2007) Effect of statin withdrawal on frequency of cardiac events after vascular surgery. Am J Cardiol 100:316–320CrossRefPubMed
19.
Zurück zum Zitat Sun YP, Zhu BQ, Browne AE et al (2001) Comparative effects of ACE inhibitors and an angiotensin receptor blocker on atherosclerosis and vascular function. J Cardiovasc Pharmacol Ther 6:175–181CrossRefPubMed Sun YP, Zhu BQ, Browne AE et al (2001) Comparative effects of ACE inhibitors and an angiotensin receptor blocker on atherosclerosis and vascular function. J Cardiovasc Pharmacol Ther 6:175–181CrossRefPubMed
20.
Zurück zum Zitat Burger W, Chemnitius JM, Kneissl GD, Rucker G (2005) Low-dose aspirin for secondary cardiovascular prevention-cardiovascular risks after its perioperative withdrawal versus bleeding risks with its continuation-review and meta-analysis. J Intern Med 257:399–414CrossRefPubMed Burger W, Chemnitius JM, Kneissl GD, Rucker G (2005) Low-dose aspirin for secondary cardiovascular prevention-cardiovascular risks after its perioperative withdrawal versus bleeding risks with its continuation-review and meta-analysis. J Intern Med 257:399–414CrossRefPubMed
21.
Zurück zum Zitat Biondi-Zoccai GG, Lotrionte M, Agostoni P et al (2006) A systematic review and meta-analysis on the hazards of discontinuing or not adhering to aspirin among 50,279 patients at risk for coronary artery disease. Eur Heart J 27:2667–2674CrossRefPubMed Biondi-Zoccai GG, Lotrionte M, Agostoni P et al (2006) A systematic review and meta-analysis on the hazards of discontinuing or not adhering to aspirin among 50,279 patients at risk for coronary artery disease. Eur Heart J 27:2667–2674CrossRefPubMed
Metadaten
Titel
Kommentar zu den „ESC Guidelines for Pre-Operative Cardiac Risk Assessment and Perioperative Cardiac Management in Non-Cardiac Surgery“
verfasst von
Prof. Dr. M. Kelm
H. Osterhues
M. Hennerici
M. Leschke
A. Osterspey
T. Lauer
Publikationsdatum
01.10.2010
Verlag
Springer-Verlag
Erschienen in
Die Kardiologie / Ausgabe 5/2010
Print ISSN: 2731-7129
Elektronische ISSN: 2731-7137
DOI
https://doi.org/10.1007/s12181-010-0293-z

Weitere Artikel der Ausgabe 5/2010

Der Kardiologe 5/2010 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.