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World J Cardiol. Oct 26, 2014; 6(10): 1100-1107
Published online Oct 26, 2014. doi: 10.4330/wjc.v6.i10.1100
Perioperative clinical variables and long-term survival following vascular surgery
Santiago Garcia, Edward O McFalls
Santiago Garcia, Minneapolis VA Healthcare System, University of Minnesota, MN 55417, United States
Edward O McFalls, Division of Cardiology (111C), VA Medical Center, Minneapolis VA Healthcare System, Professor of Medicine, University of Minnesota, MN 55417, United States
Author contributions: Garcia S and McFalls EO jointly wrote this manuscript; McFalls EO was the Principal Investigator of the Coronary Artery Revascularization Prophylaxis trial.
Supported by A career development award from the VA Office of Research and Development, No. 1IK2CX000699-01
Correspondence to: Edward O McFalls, MD, PhD, Division of Cardiology (111C), VA Medical Center, Minneapolis VA Healthcare System, Professor of Medicine, University of Minnesota, 1 Veterans Drive, Minneapolis, MN 55417, United States. mcfal00l@umn.edu
Telephone: +1-612-4673664 Fax: +1-612-7275668
Received: December 21, 2013
Revised: March 6, 2014
Accepted: September 16, 2014
Published online: October 26, 2014
Core Tip

Core tip: Patients with advanced peripheral arterial disease who need vascular surgery have a high prevalence of coronary atherosclerosis and are at increased risk of perioperative myocardial infarction. Coronary revascularization prior to the vascular operation is not an effective intervention to mitigate this risk. A strategy of widespread use of cardiac troponins in the perioperative period is recommended to detect perioperative ischemic events associated with a long-term mortality risk. The selective use of medical interventions, cardiac imaging and coronary angiography in this population deserves further study.