The Ankle-to-Arm Blood Pressure Index Predicts Risk of Cardiac Complications After Noncardiac Surgery

Fisher, Bruce; Ramsay, Gillian; Majumdar, Sumit R.; Hrazdil, Chantelle; Finegan, Barry A.; Padwal, Raj; McAlister, Finlay A.

doi:10.1213/ane.0b013e31817c6186

Cited by 12 publications

(9 citation statements)

References 29 publications

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“…24 Similarly, Fisher et al revealed that when referred for general surgery, these patients have an OR of 10.2 for the occurrence of cardiovascular events. 25 Although the results are similar, some differences between these studies and ours must be highlighted. First, our study enrolled higher perioperative cardiovascular risk patients since those classified as low risk were excluded ( Figure 2).…”

Section: Discussionmentioning

confidence: 50%

The Ankle-Brachial Index is Associated With Cardiovascular Complications After Noncardiac Surgery

et al. 2015

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Section: Discussionmentioning

confidence: 50%

The Ankle-Brachial Index is Associated With Cardiovascular Complications After Noncardiac Surgery

et al. 2015

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“…Interestingly, an abnormal ABI is also a risk factor for postoperative cardiac complications. In a cohort study of 242 patients undergoing noncardiac surgery, an ABI below 0.9 or absence of all 4 pedal pulses was a predictor of cardiac complications [adjusted odds ratio (OR)=10.2] 15. A focused physical examination for a patient with PAD should include measurement of blood pressure in both arms, auscultation for bruits (carotid, renal, and femoral), and assessment of vascular access sites.…”

Section: Preoperative Evaluationmentioning

confidence: 99%

Preoperative Cardiac Evaluation and Management of the Patient Undergoing Major Vascular Surgery

Duncan

Wijeysundera

2016

International Anesthesiology Clinics

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“…8 Furthermore, in vascular surgical patients, the severity of the peripheral vascular disease increases independent prognostic information in the presence of the RCRI risk factors. 35 35 …”

Section: Agementioning

confidence: 99%

Proposed Research Plan for the Derivation of a New Cardiac Risk Index

Biccard

2015

Anesthesia &Amp; Analgesia

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The Revised Cardiac Risk Index (RCRI) was incorporated into the American College of Cardiology/American Heart Association (ACC/AHA) recommendations for the preoperative evaluation of the cardiac patient for noncardiac surgery. The purpose of this review was to analyze studies on cardiovascular clinical risk prediction that had used the previous "standard best" model, the RCRI, as a comparator. This review aims to determine whether modification of the current risk factors or adoption of other risk factors or other risk indices would improve upon the discrimination of cardiac risk prediction when compared with the RCRI. This is necessary because recent risk prediction models have shown better discrimination for major adverse cardiac events, and the pre-eminence of the RCRI is now in question. There is now a need for a new "best standard" cardiovascular risk prediction model to supersede the RCRI. This is desirable because it would: (1) allow for a global standard of cardiovascular risk assessment; (2) provide a standard comparator in all risk prediction research; (3) result in comparable data collection; and (4) allow for individual patient data meta-analyses. This should lead to continued progress in cardiovascular clinical risk prediction. A review of the current evidence suggests that to improve the preoperative clinical risk stratification for adverse cardiac events, a new risk stratification model be built that maintains the clinical risk factors identified in the RCRI, with the following modifications: (1) additional glomerular filtration rate cut points (as opposed to a single creatinine cut point); (2) age; (3) a history of peripheral vascular disease; (4) functional capacity; and (5) a specific surgical procedural category. One would expect a substantial improvement in the discrimination of the RCRI with this approach. Although most noncardiac surgeries will benefit from a standard "generic" cardiovascular risk prediction model, there are data to suggest that patients with human immunodeficiency virus disease who are undergoing vascular surgery may benefit from specific cardiovascular risk prediction models.

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The Ankle-to-Arm Blood Pressure Index Predicts Risk of Cardiac Complications After Noncardiac Surgery

Cited by 12 publications

References 29 publications

The Ankle-Brachial Index is Associated With Cardiovascular Complications After Noncardiac Surgery

The Ankle-Brachial Index is Associated With Cardiovascular Complications After Noncardiac Surgery

Preoperative Cardiac Evaluation and Management of the Patient Undergoing Major Vascular Surgery

Proposed Research Plan for the Derivation of a New Cardiac Risk Index

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