New Developments in Cardiovascular Assessment Before Noncardiac Surgery

For patients who take daily aspirin for cardiovascular (CV) prophylaxis and are scheduled for noncardiac surgery, a dilemma is whether to continue aspirin perioperatively; the rationale would be to prevent perioperative vascular events without increasing bleeding risk. And for high-risk patients who are not on daily aspirin, would preoperative initiation of aspirin confer benefit? These questions were addressed in POISE-2, a multicenter randomized trial that involved 10,000 patients who were undergoing various noncardiac surgical procedures. Patients were eligible if they had known vascular disease (32%), were undergoing major vascular surgery (5%), or had multiple specified risk factors (83%). Nearly half the patients had been taking daily…