Table 3.

Summary of current consensus-based guidelines for preoperative cardiac evaluation.

Organization and Target Population	Recommendations
American Society of Transplantation, Kidney Transplant Candidates74	Clinical Practice Guidelines for the Evaluation of Renal Transplantation Candidates Assess CAD risk factors: age ≥45 years in men or ≥55 years in women, cigarette smoking, diabetes, hypertension, dyslipidemia, left ventricular hypertrophy Aggressive risk factor modification for all candidates “High-risk patients”, defined as those with renal disease from diabetes, prior ischemia or ≥2 risk factors should have a cardiac stress test Patients with positive stress tests should be studied by angiography for possible revascularization. Patients with critical coronary lesions should undergo revascularization prior to transplant.
Kidney Disease Outcomes Quality Initiative (K/DOQI), Dialysis Patients on the Transplant Waitlist75	Clinical Practice Guidelines for Cardiovascular Disease in Dialysis Patients Annual performance of non-invasive stress tests for dialysis patients on the kidney transplant waiting list who have diabetes, known coronary artery disease or ≥2 traditional risk factors
American College of Cardiology/American Heart Association (ACC/AHA), General Patients Preparing for Noncardiac Surgery76	Guidelines for Perioperative Cardiovascular Evaluation for Noncardiac Surgery The decision to perform CE is based on surgery-specific risk, the patient’s functional capacity and the patient’s risk factors. Patients with intermediate clinical predictors (angina pectoris, prior myocardial infarction, compensated or prior congestive heart failure, diabetes, and renal insufficiency), and moderate or excellent functional capacity >4 metabolic equivalents, should only undergo noninvasive testing if the surgical procedure is high risk