Optimizing Long-term Cardiac Management After Major Vascular SurgeryRole of β-Blocker Therapy, Clinical Characteristics, and Dobutamine Stress Echocardiography to Optimize Long-term Cardiac Management After Major Vascular Surgery

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Abstract
AFTER MAJOR vascular surgery, patients are at increased risk of cardiac complications during short- and long-term follow-up. Although the incidence of perioperative cardiac death and myocardial infarction (MI) after elective surgery has decreased gradually during the past decades, 30-day operative mortality (5%-6%) and 5-year mortality (45%), both of which arise principally from cardiac causes,1 remain high. The frequency of late postoperative cardiac morbidity reflects the high prevalence of underlying coronary artery disease (CAD) in this population. To date, the optimal approach to the diagnosis and long-term management of CAD, which is often stable or asymptomatic in these patients, is unclear.