Current concepts - Preoperative assessment of patients with known or suspected coronary disease

Cardiovascular disease is the leading cause of death in the United States, Canada, Europe, and Japan.1,2 Of the 27 million patients who undergo surgery in the United States each year, approximately 8 million have coronary artery disease or risk factors for cardiovascular disease; 1 million have perioperative cardiac complications, which result in approximately $20 billion in annual costs for in-hospital and long-term care.3 Over the next several decades, furthermore, the effects of the aging of the population will exacerbate the problem; more than 37 million patients will undergo surgery each year in the United States, of whom 40 percent. © 1995, Massachusetts Medical Society. All rights reserved.