J Korean Diabetes > Volume 12(3); 2011 > Article
The Journal of Korean Diabetes 2011;12(3):142-146.
DOI: https://doi.org/10.4093/kcd.2011.12.3.142    Published online September 1, 2011.
당뇨병환자의 수술 전 심혈관계 위험도 평가
김경아
Preoperative Assessment of Cardiac Risk in the Patient with Diabetes.
Kyoung Ah Kim
Department of Medicine, Dongguk University IIsan Hospital, Dongguk University School of Medicine, Goyang, Korea. kyoung-ah.kim@dumc.or.kr
Abstract
Approximately 50% of people with diabetes will at some point undergo surgery related to their disease. Since patients with diabetes mellitus are four times more likely to have silent ischemia and coronary artery disease compared to the risk of non-diabetic patients, they are at a higher risk for perioperative complications. Preoperative evaluation can identify many patients at increased risk of an adverse cardiac event, and appropriate perioperative management can reduce that risk. Although there is great potential to reduce perioperative cardiovascular risk, it is also impractical to perform cardiovascular testing prior to non-cardiac surgery in all patients. Therefore, it is important to determine perioperative risk and the appropriateness of cardiac testing and to provide prophylactic treatment to reduce risk. Perioperative cardiac risk stratification is determined by comorbidity, other cardiovascular risk factors, functional status, and type of surgery. By categorizing the cardiac risk, physicians can perform surgery in low risk patients without the need for cardiac testing. When preoperative risk assessment identifies intermediate- and high-risk patients, further cardiac testing might be warranted. This article reviews the perioperative evaluation of patients with diabetes with a clinical focus on cardiovascular risk.
Key Words: Diabetes mellitus, Surgery, Perioperative care, Risk management, Coronary artery disease


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