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Take Care of Heart Before Any Surgery: Experts
Date:9/29/2007

New guidelines include advice to not stop statin drug use

SATURDAY, Sept. 29 (HealthDay News) -- People with heart disease should not stop taking cholesterol-lowering drugs before any kind of noncardiac surgery, say new joint guidelines released this week by the American Heart Association and the American College of Cardiology.

The new guidelines, which update those published in 2002, provide a framework for considering and reducing a heart disease patient's risk of a cardiac event during or immediately after non-heart-related surgery.

Many heart disease patients can safely undergo noncardiac surgery without first "fixing" their heart disease with coronary bypass grafting or an artery-opening procedure, state the guidelines. They also outline how to treat patients who do need a heart procedure before noncardiac surgery, have coronary stents, or require anti-clotting medication.

"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," guideline writing committee chair Dr. Lee A. Fleisher said in a prepared statement.

"Previously, to have someone ready for surgery, many people needed diagnostic tests to look at the extent of heart disease," added Fleisher, chair of the department of anesthesiology and critical care at the Hospital of the University of Pennsylvania.

"We would do a lot of screening, and we might fix their heart disease to get them ready for the noncardiac surgery. We know now that surgical outcomes are the same in many people whether we fix the heart disease first."

The new guidelines appear online and are expected to be published in upcoming print issues of Circulation: Journal of the American Heart Association and the Journal of the American College of Cardiology.

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