Vascular Events In Surgery patIents cOhort evaluatioN - Cardiac Surgery

Conditions

Cardiac Surgery, Myocardial Infarction, Stroke, Vascular Death

Keywords

Cardiac surgery, Troponin, Vascular events, Myocardial injury, Observational cohort study, Public health

Brief summary

Worldwide over 2 million adults (\>30,000 Canadians) undergo heart surgery annually. Although heart surgery provides important survival benefits, it is associated with potential major complications such as death, stroke, and heart attack. There is promising evidence that measurement of heart injury markers after surgery will identify patients at risk of death or major complications. This study will determine the current incidence of major complications in a representative sample of 15,000 contemporary adult patients undergoing heart surgery. Knowing the current burden of complications will inform clinicians, administrators, government and granting agencies about resources required to address the problem. This study will also establish the role of measuring heart injury markers to identify important heart injury after heart surgery and the proportion that would go undetected without routine heart injury marker monitoring. This information will facilitate further studies of timely interventions. In summary, the VISION Cardiac Surgery Study addresses fundamental questions that will have profound public health implications given the millions of adults worldwide who undergo heart surgery annually.

P.J. Devereaux, Andre Lamy, Matthew T.V. Chan, René V. Allard, Vladimir V. Lomivorotov et al. (49 authors)

New England Journal of Medicine2022-03-02132 citations

10.1056/nejmoa2000803

Standardized Assessment of Global activities in the Elderly scale in adult cardiac surgery patients.

Spence J, Bosch J, Chongsi E, Lee SF, Thabane L, Mendoza P, Belley-Côté E, Whitlock R, Brady K, McIntyre WF, Lamy A, Devereaux PJ.

2021-07-289 citations

10.1016/j.bja.2021.05.037

Examination of psychological risk factors for chronic pain following cardiac surgery: protocol for a prospective observational study

Michael McGillion, Shaunattonie Henry, Jason W. Busse, Carley Ouellette, Joel Katz et al. (35 authors)

BMJ Open2019-02-019 citations

10.1136/bmjopen-2018-022995

Preoperative systemic inflammation and perioperative myocardial injury: prospective observational multicentre cohort study of patients undergoing non-cardiac surgery.

Ackland GL, Abbott TEF, Cain D, Edwards MR, Sultan P, Karmali SN, Fowler AJ, Whittle JR, MacDonald NJ, Reyes A, Paredes LG, Stephens RCM, Del Arroyo AG, Woldman S, Archbold RA, Wragg A, Kam E, Ahmad T, Khan AW, Niebrzegowska E, Pearse RM.

2018-10-0281 citations

10.1016/j.bja.2018.09.002

Interventions

None listed

Study design

Observational model

COHORT

Time perspective

PROSPECTIVE

Eligibility

Sex/Gender

ALL

Age

18 Years to No maximum

Healthy volunteers

No

Inclusion criteria

1. Age ≥ 18 years. 2. Patients who have undergone cardiac surgery. This includes coronary artery bypass grafting and all open heart procedures such as valvular repairs/replacement.

Exclusion criteria

1. Previously enrolled in the VISION Cardiac Surgery Study. 2. Patients who have undergone an isolated pericardial window, pericardiectomy, permanent pacemaker or defibrillator implantation.

Design outcomes

Primary

Measure	Time frame	Description
All-cause mortality at 30-days after surgery	30 days after surgery	All-cause mortality at 30-days after surgery
Myocardial injuries that were not identified clinically during the first 5 days after surgery	5 days after surgery	Myocardial injuries that were not identified clinically during the first 5 days after surgery
Composite of vascular death, nonfatal myocardial infarction, nonfatal cardiac arrest, nonfatal stroke, and mechanical assist device	30 days after surgery	Major vascular complications at 30 days after surgery (i.e., a composite of vascular death, nonfatal myocardial infarction, nonfatal cardiac arrest, nonfatal stroke, and mechanical assist device)

Secondary

Measure	Time frame	Description
Myocardial infarction	30 days after surgery	Myocardial infarction
Non-fatal cardiac arrest	30 days after surgery	Non-fatal cardiac arrest
Stroke	30 days after surgery	Stroke
Implantation of mechanical assist device	30 days after surgery	Implantation of mechanical assist device
Cardiac transplant	30 days after surgery	Cardiac transplant
Repeat cardiac revascularization procedures	30 days after surgery	Repeat cardiac revascularization procedures
Congestive heart failure	30 days after surgery	Congestive heart failure
New atrial fibrillation	30 days after surgery	New clinically important atrial fibrillation
Composite of vascular death, nonfatal myocardial infarction, nonfatal stroke, and mechanical assist device	30 days after surgery	Major vascular complications at 30-days after surgery (i.e., a composite of vascular death, nonfatal myocardial infarction, nonfatal stroke, and mechanical assist device)
Deep venous thrombosis	30 days after surgery	Deep venous thrombosis
Major bleeding	30 days after surgery	Major bleeding
New dialysis	30 days after surgery	New dialysis
Infection	30 days after surgery	Infection (including sternal, sepsis, pneumonia)
Re-hospitalization for a vascular reason	30 days after surgery	Re-hospitalization for a vascular reason
Chronic incisional pain	30 days after surgery	Chronic incisional pain
Frailty	30 days after surgery	Frailty assessed by PRISMA-7 questionnaire
Pulmonary embolus	30 days after surgery	Pulmonary embolus
Total mortality	30 days after surgery	Total mortality
Vascular mortality	30 days after surgery	death due to vascular cause

Countries

Australia, Brazil, Canada, China, Hong Kong, Italy, Malaysia, Poland, Russia, Spain, United Kingdom, United States

Outcome results