Atherosclerotic Disease

Over 100 million USA adults age 20 y or older have a total cholesterol >200 mg/dL.

Cardiovascular disease accounts for approximately 1 of every 3 deaths in USA (31.3%).

Cardiovascular disease increases risk of periop major adverse cardiac events (cardiac death, nonfatal myocardial infarction, and nonfatal cardiac arrest).

Approximately 3% of pts undergoing noncardiac surgery will experience a periop cardiac complication.

Increased risk of end-organ hypoperfusion (e.g., myocardial, cerebral, renal)

Increased risk of embolic events from unstable plaque rupture

Association with aneurysm formation and increased risk of dissection

Coexisting diseases and behaviors such as Htn, DM, and tobacco smoking

Possible link with increased risk of postop delirium

Lipid deposition and eventual calcification of coronary, cerebral, and peripheral arteries

Integral in the pathogenesis of coronary artery disease, carotid artery disease, peripheral arterial disease, and some forms of chronic kidney disease

Multifactorial

Risk factors: dyslipidemia, Htn, DM, endothelial dysfunction, smoking, and male sex