International journal of cardiology
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Preoperative cardiovascular evaluation is commonly performed in patients scheduled for non-cardiac surgery. The recent ACC/AHA guidelines provide an algorithm for such an evaluation but whether all patients scheduled for surgery would benefit from it is not known. We determined the yield of preoperative cardiovascular evaluation in 522 stable patients, with no prior history of heart disease, who were scheduled for elective non-cardiac surgery. ⋯ Using multivariable logistic regression analysis, the only clinical variable predictive of further testing was age > 65 years (OR = 4.47, p = 0.001). The yield of preoperative cardiovascular evaluation in stable patients scheduled for non-cardiac surgery is relatively low. Further studies are needed to identify what subgroup of patients might benefit most from it and those in whom it might not be warranted.
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Meta Analysis Comparative Study
Meta-analysis of risk of stroke and thrombo-embolism with rivaroxaban versus vitamin K antagonists in ablation and cardioversion of atrial fibrillation.
Anticoagulation in cardioversion and ablation of atrial fibrillation is imperative for reducing thrombo-embolic events. Ample information is available about the use of warfarin and vitamin K antagonists (VKA) but few trials examine safety and efficacy of rivaroxaban in these procedures. We aim to explore the hypothesis that rivaroxaban causes equal thrombo-embolic and bleeding events when used in atrial fibrillation patients undergoing ablation or cardioversion compared to VKA. ⋯ The use of rivaroxaban in ablation and cardioversion of atrial fibrillation may be associated with decreased risk of stroke and thromboembolism with equal bleeding risk compared to VKA.