ABSTRACT
INTRODUCTION In Western countries, medicine shows an obvious trend towards more aggressive surgery in older people. In recent years, the management of coronary artery disease (CAD) has evolved with the introduction of new technologies (coronary angioplasty with drug-eluting stents, beating-heart coronary bypass surgery), new medical treatments (statins, antiplatelet therapy), and cardioprotection with β-blockade or preconditioning. Assessing the patients with or at risk for CAD before surgery has become a major task for anesthesiologists and the decisions they make can considerably modify the clinical outcome of the patients. The clinician seeks to identify patients who are fit for the planned operation and those who need preoperative testing and medical treatment or coronary revascularization.
