Worldwide, annually approximately 100 million people undergo some form of non-cardiac surgery. Cardiac events, such as myocardial infarction are a major cause of perioperative morbidity and mortality in these patients. Though the true incidence of perioperative cardiac complications is difficult to assess, it is estimated that approximately 2.0–3.5% of patients undergoing major non-cardiac surgery experience a major adverse cardiac event. Furthermore an estimated 0.5–1.5% of patients die within 30 days after the surgical procedure due to a cardiovascular cause. The pathophysiology of perioperative cardiac events is complex. Similar to the non-operative setting it is thought that approximately half of all perioperative myocardial infarctions are attributable to a sustained coronary oxygen demand/supply mismatch. Coronary plaque rupture, leading to thrombus formation and subsequent vessel occlusion, is thought to be the other important cause of acute perioperative coronary syndromes.

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This research was financially supported by Lijf & Leven Foundation, Rotterdam, the Netherlands, and the Netherlands organisation for health research and development (ZonMw), the Hague, the Netherlands. Financial support for this thesis was generously provided by Erasmus University Rotterdam, Novartis Pharma B.V., and Merck KgaA.
D. Poldermans (Don)
Erasmus University Rotterdam
Erasmus MC: University Medical Center Rotterdam

Schouten, O. (2009, April 15). Perioperative Cardiovascular Risk Stratification and Modification. Retrieved from