RT Book, Section A1 Podgoreanu, Mihai V. A1 Kertai, Miklos D. A2 Longnecker, David E. A2 Mackey, Sean C. A2 Newman, Mark F. A2 Sandberg, Warren S. A2 Zapol, Warren M. SR Print(0) ID 1144136761 T1 Genomic and Precision Medicine in Anesthesia Practice T2 Anesthesiology, 3e YR 2017 FD 2017 PB McGraw-Hill Education PP New York, NY SN 9780071848817 LK accessanesthesiology.mhmedical.com/content.aspx?aid=1144136761 RD 2024/03/29 AB KEY POINTSEarly candidate gene studies and more recent genomewide association studies suggest that susceptibility to adverse perioperative events including cardiac (myocardial infarction, ventricular dysfunction, atrial fibrillation), neurologic, and renal, among other events, is genetically determined. A particular focus is now placed on determining whether a specific genetic variant warrants clinical action.Potential applications of biomarkers in perioperative medicine and critical care include prognosis, diagnosis, and monitoring of adverse outcomes, as well as informing and refining therapeutic decisions. Very few so far have been rigorously evaluated to demonstrate additive performance to existing risk stratification models (clinical validity) or change therapy (clinical utility). Most promising among those are natriuretic peptides and C-reactive protein for cardiovascular risk prediction, postoperative troponin surveillance to diagnose myocardial injury, and procalcitonin to assess infection in the critically ill.Ongoing systematic evaluation of existing genomic evidence to make clinical decisions in the perioperative continuum, update practice guidelines, and reimburse the generation and use of genomic information is required to facilitate its translation to medical practice.