Cardiovascular journal of Africa
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Clinical risk prediction is important in the prognostication of peri-operative cardiac complications and the management of high-risk cardiac patients for major non-cardiac surgery. However, the current pre-operative clinical risk indices have been derived in European and American patients and not validated in South African patients. The purpose of this study was to evaluate the utility of the clinical risk predictors identified in Lee's revised cardiac risk index and in the African arm of the INTERHEART study, in predicting cardiac mortality following vascular surgery in South African patients. ⋯ However, based on the sample size of this study, a type 2 or b error may have resulted in the other risk predictors not being identified as important clinical predictors of cardiac mortality. Therefore, until such time as a study of adequate power is conducted, a history of ischaemic heart disease, congestive cardiac failure, diabetes and cerebrovascular accidents should still be considered to be important clinical risk predictors in South African surgical patients. In conclusion, an elevated serum creatinine and a positive history for smoking are important clinical predictors of cardiac mortality in South African patients following elective or urgent vascular surgery.