ABSTRACT
Over 30 million patients undergo noncardiac surgery annually in the USA, 4 million of whom are at risk of having coronary artery disease (CAD) on the basis of clinical risk factors. More than 1 million patients have cardiovascular complications postoperatively (1). The health care costs associated with these adverse cardiac outcomes have been estimated to be in excess of $10 billion annually in the USA. With the shifting demographics of the US population, increasingly the elderly represent the majority on whom surgical procedures are performed. Up to 80% of patients over 80 years have identifiable cardiovascular diseases and that is the leading cause of mortality (2).
