Which risk factors are associated with an increased risk of major adverse cardiac events during noncardiac surgery?

Congestive heart failure is a significant risk factor for major adverse cardiac events during noncardiac surgery. Patients with congestive heart failure often have compromised cardiac function, which increases the likelihood of complications such as myocardial infarction, heart failure exacerbation, or arrhythmias during the stress of surgery. The severity of heart failure correlates with the risk; therefore, identifying patients with this condition is crucial for preoperative assessment and optimizing their management prior to surgical procedures.

Additionally, other conditions, such as elevated serum creatinine or smoking, can also impact cardiac risk, but they have different mechanisms and varying levels of correlation with adverse cardiac events. For example, while elevated serum creatinine indicates potential kidney dysfunction and could contribute to a greater risk of cardiovascular complications, the direct association of congestive heart failure with cardiac events during surgery is particularly strong and well-documented.