Symptoms of coronary artery disease predict risks of surgery

doi:10.1136/bmj.311.7005.628b

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Neil Gillespie,
Dawood Darbar

Research fellow Department of Cardiology, Ninewells Hospital and Medical School, Dundee DD2 1UB
Research fellow Division of Clinical Pharmacology, Vanderbilt University School of Medicine, Nashville, TN, USA

EDITOR,--N Mamode and colleagues' editorial on the assessment of patients before surgery is a reminder of the lack of reliable algorithms for the non-invasive assessment of operative risk.1 Even with patients at high risk, such as those with peripheral vascular disease, there is no uniform strategy to predict the risk of perioperative cardiac events. Approaches ranging from invasive preoperative cardiac catheterisation to merely 12 lead electrocardiography have been advocated to assess the risk.

In attempts to predict the risk of surgery in patients with …