Guideline Update on Perioperative Cardiovascular Evaluation for Noncardiac Surgery:

1.1. Purpose of the Expedited Update
Since the publication of the previous guidelines on perioperative cardiovascular evaluation for noncardiac surgery in 2002, the issue of perioperative beta blockade for non-cardiac surgery has taken on increased importance. Specifically, the Physicians Consortium for Performance Improvement and the Surgical
Care Improvement Project have both identified perioperative beta blockade as a quality measure. Given the importance of these quality measures for both public reporting and eventual pay-for-performance, and the recent series of publications on the subject, it became imperative to update the recommendations
related to beta blockade. Therefore, we have chosen to expedite the review of the literature on perioperative beta blockade in order to produce recommendations that can be used in these national quality initiatives. In general, ACC/AHA Class I and III indications for therapy identify potential
dimensions of care and processes for performance measurement; however, not all Class I and III guidelines recommendations should be selected for performance measurement (1).