PT  - JOURNAL ARTICLE
AU  - Lauer, Michael S.
TI  - Cardiovascular medicine update 2007: Perioperative risk, carotid angioplasty, drug-eluting stents, stronger statins
DP  - 2007 Jul 01
TA  - Cleveland Clinic Journal of Medicine
PG  - 505--511
VI  - 74
IP  - 7
4099  - http://www.ccjm.org/content/74/7/505.short
4100  - http://www.ccjm.org/content/74/7/505.full
SO  - Cleve Clin J Med2007 Jul 01; 74
AB  - Some recent clinical trials have concluded the following: Patients who need noncardiac surgery and who are at risk of major cardiac events should not undergo revascularization with the aim of achieving a better perioperative outcome. They should have an office evaluation only and be prescribed a beta-blocker, if indicated.Except for unusual, high-risk cases, patients at risk of stroke due to atherosclerotic carotid artery stenosis should undergo carotid endarterectomy rather than carotid stenting. Because the technology is still developing, however, carotid stenting may still be appropriate as part of a clinical trial.Although drug-eluting coronary stents reduce the risk of restenosis in the short term, they pose a small but significant risk of in-stent thrombosis. Clopidogrel (Plavix) should be prescribed for at least a year following drug-eluting stent placement, and perhaps indefinitely.Patients with known coronary heart disease have better outcomes if they receive aggressive statin therapy (eg, atorvastatin [Lipitor] 80 mg/day) to lower their serum levels of low-density lipoprotein cholesterol to less than 70 mg/dL.