American University of Beirut (AUB)-HAS2 Cardiovascular Risk Index

• Use results in conjunction with other patient-specific and procedure-specific factors to guide discussions on perioperative risk and adjust care plans.
• For enhanced risk evaluation and management, consider combining this tool’s results with an assessment of symptoms and functional capacity (e.g., Duke Activity Status Index).

• Low risk (score 0-1):

  • No further cardiovascular testing is required.

  • Ensure optimal therapy for any underlying cardiovascular disease.

• Intermediate (score 2-3) and high risk (score >3):

  • Consider a baseline ECG and ensure cardiovascular disease treatment is optimized.

  • Additional cardiovascular evaluation, including laboratory studies (e.g., BNP, troponin), stress testing, echocardiography, and/or cardiology consultation, may be appropriate if the patient has symptoms and/or if the results could alter management.

• Address additional risk factors not covered by this tool (e.g., glucose and blood pressure management).

• For more detailed recommendations, please refer to the 2024 perioperative cardiovascular management guidelines from the ACC/AHA Joint Committee on Clinical Practice Guidelines.

A high-risk score should not necessarily prevent or delay a patient from undergoing urgent or emergent surgery, as the benefits may outweigh the risks. Clinical judgment, along with surgical, cardiology input, and patient preferences, should be considered.