Perioperatieve risicoreductie bij vaatoperaties door cardioprotectieve medicatie

- Cardiovascular complications are the leading cause of death after non-cardiac surgery.

- Preoperrative indentification of patients with underlying coronary artery disease is important, and appropriate treatment strategies should be implemented in these patients in order to reduce the risc of perioperative complications.

- Based on recent findings, preoperative risk stratification models have been developed to identify high-, intermediate- or low-risk patients; the concentration of natriuretic peptides is a promising new preoperative risk marker.

- β-blockers considerably reduce this risk. In clinical practice, important factors are adequate β-blocker dosage, tight perioperative heart-rate control and continuation of β-blockers after discharge.

- Recently, statons have emerged as drugs with perioperative cardio-protective properties, but more randomized clinical trials are needed before routine administration of statins can be recommended.

- Perioperative medical management should focus on improvements not only in the short term but also in the long term.

Ned Tijdschr Geneeskd. 2008;152:2606-11