This AHA/ACC multi-society guideline evaluates perioperative cardiovascular management for adult patients undergoing noncardiac surgery, updating the 2014 ACC/AHA guideline with evidence from a comprehensive literature search (August 2022–March 2023) across MEDLINE, EMBASE, Cochrane Library, and other databases.
The guideline supersedes the 2014 ACC/AHA perioperative guideline and provides updated recommendations covering preoperative cardiovascular evaluation, pharmacological therapies, perioperative monitoring, and device management for cardiovascular disease and associated conditions in noncardiac surgery patients.
Literature search was conducted from August 2022 to March 2023 only, meaning studies published after March 2023 are not incorporated; as a consensus guideline, individual recommendations carry varying levels of supporting evidence.
Clinicians managing adults before noncardiac surgery should adopt this 2026 guideline as the current standard, replacing the 2014 ACC/AHA document, particularly regarding updated pharmacological therapies, monitoring strategies, and device use for perioperative cardiovascular risk.
Explore related topics
