New Guidelines for Cardiovascular Management in Noncardiac Surgery Released

The American Heart Association (AHA) and American College of Cardiology (ACC) have released new guidelines for cardiovascular management of adults undergoing noncardiac surgery, updating recommendations last issued in 2014. Published in the journals Circulation and JACC, the guidelines provide evidence-based recommendations for assessing and managing cardiovascular risk factors in surgical patients.

With approximately 300 million noncardiac surgeries performed worldwide each year, the guidelines aim to help clinicians minimize cardiovascular complications in patients with known or potential risk factors. The recommendations cover patient evaluation, appropriate use of cardiovascular testing and screening, and management of conditions before, during and after surgery.

Key updates include more judicious use of preoperative cardiac stress testing, guidance on newer diabetes and obesity medications, and recommendations for managing blood thinners perioperatively. The guidelines also address emerging issues like myocardial injury after noncardiac surgery (MINS) and postoperative atrial fibrillation.

Dr. Annemarie Thompson, chair of the guideline writing group, emphasized the importance of a multidisciplinary approach, stating, 'A team-based approach, including surgeons, primary care physicians, cardiologists, internal medicine doctors and other medical specialists, is needed to optimize care for patients with cardiovascular conditions and risk factors before, during and after surgery.'

The guidelines were developed in collaboration with multiple medical societies and reflect a decade of new evidence since the last update. They provide a comprehensive resource for the many healthcare professionals involved in perioperative cardiovascular care, with the ultimate goal of improving surgical outcomes and minimizing complications in at-risk patients.

As the U.S. population ages and more people live with chronic cardiovascular conditions, these updated recommendations will play a crucial role in guiding perioperative management and reducing surgical risks. Healthcare providers across specialties are encouraged to review and implement the new evidence-based guidelines in their practice.