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tances evolve, with updates posted continuously on the IOPC website (https//iopc.online/). Cardiac stress testing is often performed prior to noncardiac surgery, although trends in use of preoperative stress testing and the effect of testing on cardiovascular outcomes are currently unknown. To describe temporal trends and outcomes of preoperative cardiac stress testing from 2004 to 2017. Cross-sectional study of patients undergoing elective total hip or total knee arthroplasty from 2004 to 2017. Trend analysis was conducted using Join

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