The Revised Cardiac Risk Index (RCRI/Lee Index) assigns 1 point each for six clinical variables to predict major adverse cardiac events (MACE) perioperatively. Which of the following is NOT one of the six RCRI variables?

• A Ischaemic heart disease (history of MI, positive stress test, or current angina)
• B Congestive heart failure
• C Hypertension requiring antihypertensive therapy ✓
• D Preoperative serum creatinine >2.0 mg/dL (176 µmol/L)

Explanation

The six RCRI variables are: (1) ischaemic heart disease; (2) congestive heart failure; (3) cerebrovascular disease (TIA or stroke); (4) insulin-dependent diabetes mellitus; (5) preoperative creatinine >2.0 mg/dL; and (6) high-risk surgery (suprainguinal vascular, intraperitoneal, or intrathoracic). Hypertension per se is NOT one of the six RCRI variables. RCRI score 0 = <1% MACE risk; score 1 = ~1%; score 2 = ~2.5%; score ≥3 = ~5.4%. An elevated RCRI may prompt additional cardiac evaluation before elective high-risk surgery.

Reference: Morgan & Mikhail's Clinical Anesthesiology, 6th ed.

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Written and medically reviewed by the StethoPrep medical team.