ABSTRACT
INTRODUCTION With increasing life expectancy and improved surgical technology, an increasing number of elderly patients with cardiovascular disease or significant cardiovascular risk factors will undergo major surgery. More than 5% of an unselected surgical population undergoing noncardiac surgery will suffer from severe perioperative cardiovascular complications including myocardial infarction and cardiac death. The incidence of adverse cardiac events may reach 30% in high-risk patients undergoing vascular surgery, causing a substantial financial burden of perioperative health care costs (1). In the United States of America, it is estimated that approximately 1 million patients suffer a major cardiac complication annually, including 500,000 myocardial infarctions. In the United Kingdom, there are approximately 20,000 deaths within 30 days of surgery every year, 9000 of which have a cardiac cause (2,3). Thus, therapeutic measures to lower the incidence of perioperative cardiovascular complications are justified.
