Coronary Computed Angiography and Coronary Artery Calcium Score for Preoperative Cardiovascular Risk Stratification in Patients Undergoing Noncardiac Surgery

Perioperative and long-term postoperative major adverse cardiovascular events (MACE) are a leading cause of morbidity and mortality in patients undergoing noncardiac surgery. In selected high-risk patients, when information about cardiovascular status may influence surgical decisions, preoperative r...

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Main Authors: Ioannis Kyriakoulis, Sriram S. Kumar, Georgios D. Lianos, Dimitrios Schizas, Damianos G. Kokkinidis
Format: Article
Language:English
Published: MDPI AG 2025-04-01
Series:Journal of Cardiovascular Development and Disease
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Online Access:https://www.mdpi.com/2308-3425/12/4/159
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author Ioannis Kyriakoulis
Sriram S. Kumar
Georgios D. Lianos
Dimitrios Schizas
Damianos G. Kokkinidis
author_facet Ioannis Kyriakoulis
Sriram S. Kumar
Georgios D. Lianos
Dimitrios Schizas
Damianos G. Kokkinidis
author_sort Ioannis Kyriakoulis
collection DOAJ
description Perioperative and long-term postoperative major adverse cardiovascular events (MACE) are a leading cause of morbidity and mortality in patients undergoing noncardiac surgery. In selected high-risk patients, when information about cardiovascular status may influence surgical decisions, preoperative risk stratification is reasonable, with stress imaging being the preferred method. Coronary computed angiography (CCTA) and coronary artery calcium score (CACS) offer direct anatomical assessment of atherosclerotic coronary arteries and help gauge the extent and severity of coronary artery disease. Strong evidence supports that CCTA and CACS, either alone or in combination, are reliable methods for assessing the risk of both perioperative and long-term postoperative MACE, often demonstrating equal or superior prognostic performance compared to traditional imaging tools. Moreover, integrating CCTA or CACS into standard preoperative imaging protocols further enhances perioperative risk prediction and improves the ability to accurately stratify patients. Future research is needed to better define the role of CCTA and CACS in preoperative cardiovascular risk evaluation of patients undergoing noncardiac surgery.
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spelling doaj-art-a8e7a3504daa4ab0ada0a25a90b3e3b92025-08-20T02:28:23ZengMDPI AGJournal of Cardiovascular Development and Disease2308-34252025-04-0112415910.3390/jcdd12040159Coronary Computed Angiography and Coronary Artery Calcium Score for Preoperative Cardiovascular Risk Stratification in Patients Undergoing Noncardiac SurgeryIoannis Kyriakoulis0Sriram S. Kumar1Georgios D. Lianos2Dimitrios Schizas3Damianos G. Kokkinidis4Faculty of Medicine, School of Health Sciences, University of Thessaly, 41100 Larissa, GreeceDepartment of Medicine, Jacobi Medical Center, 1400 Pelham Parkway South, 3N1, Suite B, Bronx, NY 10461, USADepartment of Surgery, University Hospital of Ioannina, 45110 Ioannina, GreeceDepartment of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, 11527 Athens, GreeceHeart and Vascular Institute, Yale New Haven Health, Lawrence and Memorial Hospital, New London, CT 06320, USAPerioperative and long-term postoperative major adverse cardiovascular events (MACE) are a leading cause of morbidity and mortality in patients undergoing noncardiac surgery. In selected high-risk patients, when information about cardiovascular status may influence surgical decisions, preoperative risk stratification is reasonable, with stress imaging being the preferred method. Coronary computed angiography (CCTA) and coronary artery calcium score (CACS) offer direct anatomical assessment of atherosclerotic coronary arteries and help gauge the extent and severity of coronary artery disease. Strong evidence supports that CCTA and CACS, either alone or in combination, are reliable methods for assessing the risk of both perioperative and long-term postoperative MACE, often demonstrating equal or superior prognostic performance compared to traditional imaging tools. Moreover, integrating CCTA or CACS into standard preoperative imaging protocols further enhances perioperative risk prediction and improves the ability to accurately stratify patients. Future research is needed to better define the role of CCTA and CACS in preoperative cardiovascular risk evaluation of patients undergoing noncardiac surgery.https://www.mdpi.com/2308-3425/12/4/159coronary artery calcium score (CACS)coronary computed tomography angiography (CCTA)major adverse cardiovascular events (MACE)noncardiac surgerypreoperative risk stratification
spellingShingle Ioannis Kyriakoulis
Sriram S. Kumar
Georgios D. Lianos
Dimitrios Schizas
Damianos G. Kokkinidis
Coronary Computed Angiography and Coronary Artery Calcium Score for Preoperative Cardiovascular Risk Stratification in Patients Undergoing Noncardiac Surgery
Journal of Cardiovascular Development and Disease
coronary artery calcium score (CACS)
coronary computed tomography angiography (CCTA)
major adverse cardiovascular events (MACE)
noncardiac surgery
preoperative risk stratification
title Coronary Computed Angiography and Coronary Artery Calcium Score for Preoperative Cardiovascular Risk Stratification in Patients Undergoing Noncardiac Surgery
title_full Coronary Computed Angiography and Coronary Artery Calcium Score for Preoperative Cardiovascular Risk Stratification in Patients Undergoing Noncardiac Surgery
title_fullStr Coronary Computed Angiography and Coronary Artery Calcium Score for Preoperative Cardiovascular Risk Stratification in Patients Undergoing Noncardiac Surgery
title_full_unstemmed Coronary Computed Angiography and Coronary Artery Calcium Score for Preoperative Cardiovascular Risk Stratification in Patients Undergoing Noncardiac Surgery
title_short Coronary Computed Angiography and Coronary Artery Calcium Score for Preoperative Cardiovascular Risk Stratification in Patients Undergoing Noncardiac Surgery
title_sort coronary computed angiography and coronary artery calcium score for preoperative cardiovascular risk stratification in patients undergoing noncardiac surgery
topic coronary artery calcium score (CACS)
coronary computed tomography angiography (CCTA)
major adverse cardiovascular events (MACE)
noncardiac surgery
preoperative risk stratification
url https://www.mdpi.com/2308-3425/12/4/159
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