以前如何管理心脏和中风的风险, during and after non-heart surgery

对于那些做了与心脏无关的手术的人, 新的指导方针详细说明了如何控制心脏病和中风的风险, 手术中和手术后.

的 的指导方针, 基于过去十年积累的证据, address issues such as how to minimize testing to avoid unnecessary costs and delays in surgery and how to properly manage blood pressure and heart medications. 的y were issued Tuesday by the 美国心脏协会 and American College of Cardiology. 其他7个医学协会也支持新的指导方针.

"的re is a wealth of new evidence about how best to evaluate and manage perioperative cardiovascular risk in patients undergoing noncardiac surgery," Dr. 指导方针编写小组的负责人安妮玛丽·汤普森(Annemarie Thompson)说 线上电子游戏飞禽走兽稿. 汤普森是一名麻醉学教授, medicine and population health sciences at Duke University School of Medicine in Durham, 北卡罗莱纳.

“全球, 每年大约有3亿例非心脏手术, which underscores the need to summarize and interpret the evidence to assist clinicians in managing patients who present for surgery,她说.

更新后的指南, 哪些目标是跨学科的卫生专业人员, were written for patients scheduled for non-heart surgery from the time they're evaluated before surgery through postoperative care. 的y include recommendations for patients with coronary artery disease, 肥厚性心肌病, 心脏瓣膜病, 肺动脉高压, 阻塞性睡眠呼吸暂停和既往中风. 它们取代了2014年发布的旧指南.

“你.S. population is getting older and is living longer with chronic health conditions, 包括慢性心脏和血管疾病,汤普森说. “一个多学科, 以团队为基础的方法”，包括外科医生, primary care physicians and specialists is needed to ensure optimal care for people with cardiovascular conditions and risk factors before, 手术中和手术后, 她说.

的 new 的指导方针 cover the use of cardiovascular testing and screening, patient evaluations and assessments and the most recent evidence for how to manage cardiovascular conditions in people who need any surgery that requires general or regional anesthesia.

的y also include recommendations for people taking new therapies to manage diabetes, 心力衰竭和肥胖. 具体地说, the 的指导方针 recommend that sodium-glucose cotransporter-2 (SGLT2) inhibitors be discontinued three to four days before surgery to minimize the risk of complications. 的 的指导方针 also include recommendations for discontinuing and resuming the use of blood thinners.

从之前的研究中, 高血压等疾病, 2型糖尿病, 男性大于55岁，女性大于65岁, smoking and obesity are known risk factors that predispose patients to cardiovascular disease,汤普森说. 还有一些人有早发性冠状动脉疾病的家族史, 这也会增加他们的风险. 的se 的指导方针 are written with the understanding that these and other cardiovascular risk factors and conditions can contribute to negative surgical outcomes if they are unrecognized or not optimized before surgery."

更新后的指南 also focus on the need for additional research in two areas.

One is a newly identified condition known as myocardial injury after noncardiac surgery, 或分钟, which involves injury to the heart that occurs during or shortly after surgery. Little is known about what causes MINS or how to prevent or manage it.

More research is also needed to understand how to manage irregular heart rhythms that may occur during or after noncardiac surgery, 哪些会增加中风的风险.