2026 Guideline for Perioperative Cardiovascular Management for Noncardiac Surgery
Updated: September 29, 2026
- Reaffirmed: This 2026 guideline replaces the 2024 perioperative guideline. The Surveillance Committee evaluated the evidence published through March 2026 and determined that the 2024 guideline remains valid and current. No new evidence was identified that changed the existing recommendations. The recommendations, supportive text, figures, tables, and references are identical to those in the 2024 publication. Details of the process are described in the 2026 ACC/AHA Methodology and Policies Manual.
- This Guideline for Perioperative Cardiovascular Management for Noncardiac Surgery (NCS) provides a stepwise approach to perioperative cardiac assessment and guides health care professionals to determine when surgery should proceed or when a pause is warranted for further evaluation.
- This guideline addresses evidence-based management strategies (including pharmacologic therapies, perioperative monitoring, and devices) for cardiovascular disease (CVD) and associated medical conditions.
- The overarching goal of perioperative evaluation and management is to encourage patient engagement and facilitate shared decision-making through clear and understandable communication regarding perioperative cardiovascular risk and recommendations for risk mitigation and management.
Video: 2024 Guideline for Perioperative Cardiovascular Management for Noncardiac Surgery
Annemarie Thompson, MD, MBA, FAHA Kirsten Fleischmann, MD, MPH, FACC and Nathaniel Smilowitz, MD, MS, FACC they discuss the new guideline's, updates of the latest evidence-based practices, which reflect a significant shift from the 2014 guidelines, emphasizing the integration of new data, modular format for easier updates, and expanded use of biomarkers.
Supporting Materials
- Top Things to Know: 2024 Guideline for Perioperative Cardiovascular Management for Noncardiac Surgery
- Key Patient Messages: Guideline for Perioperative Cardiovascular Management for Noncardiac Surgery
- News Release: New guideline details how to manage CVD risk before, during & after noncardiac surgery
Slide Sets
- AHA Clinical Slide Series: 2024 Guideline for Perioperative Cardiovascular Management for Noncardiac Surgery
Download AHA Clinical Slide Series: 2024 Guideline for Perioperative Cardiovascular Management for Noncardiac Surgery (PPTX) - 2024 Guideline for Perioperative Cardiovascular Management for Noncardiac Surgery Slide Set
Download 2024 AHA Guideline Slide Set (PDF)
Related Resources
- Hub - 2026 Guideline for Perioperative Cardiovascular Management for Noncardiac Surgery
- Pocket Guide: Perioperative Cardiovascular Evaluation and Management of Patients Undergoing Noncardiac Surgery
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