Groups Publish Guidelines For Treating Patients With Heart Disease

Main Category: Cardiovascular / Cardiology
Article Date: 02 Oct 2007 - 11:00 PDT

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A panel of experts from the American College of Cardiology and the American Heart Association on Thursday issued new guidelines on performing noncardiac surgery on patients with heart disease, the New York Times reports. The 82-page guidelines will be published in the Oct. 23 issue of the journal Circulation.

The recommendations aim to reduce heart patients' risks during surgery and cover a number of issues, such as when to stop taking certain drugs and when to receive a stent or have coronary bypass surgery in advance of a separate procedure. They were culled from a critical review of several studies, with a focus on studies published after the last set of guidelines was released in 2002.

Some key points of the guidelines are that patients do not necessarily have to receive cardiac surgery to fix minor problems before undergoing nonheart procedures. The panel says patients should be evaluated and treated before noncardiac surgery only if they have severe angina, late-stage heart failure, serious arrhythmias or severe heart valve disease. In addition, the guidelines say patients should continue taking statins before nonheart surgery and should stop taking anticlotting drugs for as short a duration as possible, according to the Times.

The panel also said that researchers should focus future studies on areas of the guidelines where data are lacking (Altman, New York Times, 9/28). Lee Fleisher, a professor at the University of Pennsylvania School of Medicine who headed the panel, said, "In the past, we had to go on indefinite evidence, but now there are a number of studies published to help us direct best practices." Fleisher said that if the condition is not severe, "fixing the heart first doesn't make much of a difference in how well they do in surgery," adding, "There is certainly no evidence it will make any difference when it comes to outcome" (Stewart, Newark Star Ledger, 9/28).

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