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Using beta-blockers to cut perioperative risk in CAD. Cardioprotective strategies for noncardiac surgery.

Postoperative adverse myocardial ischemic events, such as infarction, unstable angina, and cardiac death, are common in patients with coronary artery disease (CAD). These events can be prevented in many patients with strategies such as the perioperative use of beta-blockers. In this article, the authors present four cases and discuss perioperative evaluation of patients having a noncardiac operation to determine risk of an adverse cardiac event after the procedure. Evidenced-based approaches to reducing the chances of an undesirable outcome in high-risk patients, such as preoperative testing and procedures and the use of beta-blockers, are presented.