Incidence of major cardiac complications increases with the number of risk factors

Among 4513 patients, the incidence of a major cardiac complication increases with a higher cardiac risk index (1 to 4), which is based upon six independent predictors, including high-risk type of surgery, history of ischemic heart disease, history of heart failure, history of cerebrovascular disease, preoperative treatment with insulin, and preoperative serum creatinine >2.0 mg/dL (177 mol/L). By definition, patients undergoing abdominal aortic aneurysm (AAA), thoracic, and abdominal procedures were excluded from class I. In all subsets, except patients undergoing AAA, there was a statistically significant trend toward greater risk with higher risk class.