ABSTRACT
Over 30 million patients undergo noncardiac surgery annually in the United States,
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 United States. With the
shifting demographics of the U.S. population, increasingly the elderly represent the
majority on whom nearly all surgical procedures are performed.
