Journal of Vascular Surgery
Volume 52, Issue 3 , Pages 674-683.e3 , September 2010

The Vascular Study Group of New England Cardiac Risk Index (VSG-CRI) predicts cardiac complications more accurately than the Revised Cardiac Risk Index in vascular surgery patients

Presented at the Thirty-sixth Annual New England Society for Vascular Surgery, Boston, Mass, Oct 3, 2009.

  • Daniel J. Bertges, MD, RVT

      Affiliations

    • Divisions of Vascular Surgery of University of Vermont College of Medicine, Burlington, Vt
    • Corresponding Author InformationCorrespondence: Daniel J. Bertges, MD, FACS, RVT, Associate Professor of Surgery, University of Vermont College of Medicine, Division of Vascular Surgery Fletcher Allen Health Care, 111 Colchester Ave, Smith 338, Burlington, VT 05401
    • ,
  • Philip P. Goodney, MD

      Affiliations

    • Dartmouth Hitchcock Medical Center, Lebanon, NH
    • ,
  • Yuanyuan Zhao, MD

      Affiliations

    • Dartmouth Hitchcock Medical Center, Lebanon, NH
    • ,
  • Andres Schanzer, MD

      Affiliations

    • University of Massachusetts Medical School, Worcester, Mass
    • ,
  • Brian W. Nolan, MD

      Affiliations

    • Dartmouth Hitchcock Medical Center, Lebanon, NH
    • ,
  • Donald S. Likosky, PhD

      Affiliations

    • Dartmouth Hitchcock Medical Center, Lebanon, NH
    • ,
  • Jens Eldrup-Jorgensen, MD

      Affiliations

    • Maine Medical Center, Portland, Me
    • ,
  • Jack L. Cronenwett, MD

      Affiliations

    • Dartmouth Hitchcock Medical Center, Lebanon, NH
    • ,
  • Vascular Study Group of New England

Received 19 December 2009 ,Accepted 17 March 2010.

References 

  1. Goldman L, Caldera DL, Nussbaum SR, Southwick FS, Krogstad D, Murray B, et al. Multifactorial index of cardiac risk in noncardiac surgical procedures. N Engl J Med. 1977;297:845–850
  2. Detsky AS, Abrams HB, Forbath N, Scott JG, Hilliard JR. Cardiac assessment for patients undergoing noncardiac surgery (A multifactorial clinical risk index). Arch Intern Med. 1986;146:2131–2134
  3. Kheterpal S, O'Reilly M, Englesbe MJ, Rosenberg AL, Shanks AM, Zhang L, et al. Preoperative and intraoperative predictors of cardiac adverse events after general, vascular, and urological surgery. Anesthesiology. 2009;110:58–66
  4. Cooperman M, Pflug B, Martin EW, Evans WE. Cardiovascular risk factors in patients with peripheral vascular disease. Surgery. 1978;84:505–509
  5. Yeager RA, Weigel RM, Murphy ES, McConnell DB, Sasaki TM, Vetto RM. Application of clinically valid cardiac risk factors to aortic aneurysm surgery. Arch Surg. 1986;121:278–281
  6. Eagle KA, Coley CM, Newell JB, Brewster DC, Darling RC, Strauss HW, et al. Combining clinical and thallium data optimizes preoperative assessment of cardiac risk before major vascular surgery. Ann Intern Med. 1989;110:859–866
  7. Lette J, Waters D, Lassonde J, Rene P, Picard M, Laurendeau F, et al. Multivariate clinical models and quantitative dipyridamole-thallium imaging to predict cardiac morbidity and death after vascular reconstruction. J Vasc Surg. 1991;14:160–169
  8. L'Italien GJ, Paul SD, Hendel RC, Leppo JA, Cohen MC, Fleisher LA, et al. Development and validation of a Bayesian model for perioperative cardiac risk assessment in a cohort of 1,081 vascular surgical candidates. J Am Coll Cardiol. 1996;27:779–786
  9. Bartels C, Bechtel JF, Hossmann V, Horsch S. Cardiac risk stratification for high-risk vascular surgery. Circulation. 1997;95:2473–2475
  10. Karkos CD, Thomson GJ, Hughes R, Hollis S, Hill JC, Mukhopadhyay US. Prediction of cardiac risk before abdominal aortic reconstruction: comparison of a revised Goldman Cardiac Risk Index and radioisotope ejection fraction. J Vasc Surg. 2002;35:943–949
  11. Lee TH, Marcantonio ER, Mangione CM, Thomas EJ, Polanczyk CA, Cook EF, et al. Derivation and prospective validation of a simple index for prediction of cardiac risk of major noncardiac surgery. Circulation. 1999;100:1043–1049
  12. Bauer SM, Cayne NS, Veith FJ. New developments in the preoperative evaluation and perioperative management of coronary artery disease in patients undergoing vascular surgery. J Vasc Surg. 2010;51:242–251
  13. Cronenwett JL, Likosky DS, Russell MT, Eldrup-Jorgensen J, Stanley AC, Nolan BW. A regional registry for quality assurance and improvement: the Vascular Study Group of Northern New England (VSGNNE). J Vasc Surg. 2007;46:1093–1101discussion 1101-2
  14. Swets JA, Dawes RM, Monahan J. Better decisions through science. Sci Am. 2000;283:82–87
  15. Goodney PP, Likosky DS, Cronenwett JL Vascular Study Group of Northern New E. Factors associated with stroke or death after carotid endarterectomy in Northern New England. J Vasc Surg. 2008;48:1139–1145
  16. McFalls EO, Ward HB, Moritz TE, Goldman S, Krupski WC, Littooy F, et al. Coronary-artery revascularization before elective major vascular surgery. N Engl J Med. 2004;351:2795–2804
  17. Monaco M, Stassano P, Di Tommaso L, Pepino P, Giordano A, Pinna GB, et al. Systematic strategy of prophylactic coronary angiography improves long-term outcome after major vascular surgery in medium- to high-risk patients: a prospective, randomized study. J Am Coll Cardiol. 2009;54:989–996
  18. Devereaux PJ, Yang H, Yusuf S, Guyatt G, Leslie K, Villar JC, et al. Effects of extended-release metoprolol succinate in patients undergoing non-cardiac surgery (POISE trial): a randomised controlled trial. Lancet. 2008;371:1839–1847
  19. Lindenauer PK, Pekow P, Wang K, Mamidi DK, Gutierrez B, Benjamin EM. Perioperative beta-blocker therapy and mortality after major noncardiac surgery. N Engl J Med. 2005;353:349–361
  20. Press MJ, Chassin MR, Wang J, Tuhrim S, Halm EA. Predicting medical and surgical complications of carotid endarterectomy: comparing the risk indexes. Arch Intern Med. 2006;166:914–920
  21. Schouten O, Kok NF, Hoedt MT, van Laanen JH, Poldermans D. The influence of aneurysm size on perioperative cardiac outcome in elective open infrarenal aortic aneurysm repair. J Vasc Surg. 2006;44:435–441
  22. Welten GM, Schouten O, van Domburg RT, Feringa HH, Hoeks SE, Dunkelgrun M, et al. The influence of aging on the prognostic value of the revised cardiac risk index for postoperative cardiac complications in vascular surgery patients. Eur J Vasc Endovasc Surg. 2007;34:632–638
  23. Fleisher LA, Beckman JA, Brown KA, Calkins H, Chaikof EL, Fleischmann KE, et al. ACC/AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery) Developed in Collaboration With the American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Rhythm Society, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, and Society for Vascular Surgery. J Am Coll Cardiol. 2007;50:1707–1732

 Supported in part by a grant from the Center for Medicare and Medicaid Services.

 Competition of interest: None.

 The editors and reviewers of this article have no relevant financial relationships to disclose per the JVS policy that requires reviewers to decline review of any manuscript for which they may have a competition of interest.

 Additional material for this article may be found online at www.jvascsurg.org.

PII: S0741-5214(10)00774-3

doi: 10.1016/j.jvs.2010.03.031

Journal of Vascular Surgery
Volume 52, Issue 3 , Pages 674-683.e3 , September 2010

Article Tools

* Image Usage & Resolution