Cardiac biOMarkers in Patients with Aortic StenosiS (COMPASS)
Research type
Research Study
Full title
Cardiac biOMarkers in Patients with Aortic StenosiS (COMPASS)
IRAS ID
163406
Contact name
Atul Anand
Contact email
Sponsor organisation
University of Edinburgh
Duration of Study in the UK
3 years, 0 months, 0 days
Research summary
Aortic stenosis describes a narrowed aortic heart valve, affecting 12% of over 75 year olds. Many will develop symptoms such as shortness of breath and chest pain, so requiring major cardiac surgery (aortic valve replacement, AVR). Unfortunately, many older patients do not gain envisioned improvements in quality of life or function after surgery. Indeed some experience harm including stroke and post-operative confusion (delirium). These individuals have a greater risk of death, loss of independence and future dementia. Appropriate patient selection to minimise harm is therefore important.
Troponin is a protein released into the blood from damaged heart muscle. It is routinely used to detect heart attacks. Our pilot data suggests an additional role in identifying progression of aortic stenosis. To investigate this we will carry out an observational study, measuring blood levels in 100 patients with aortic stenosis every 3 months for up to 18 months, to see how changes in troponin relate to symptoms and the need for surgery. Alongside this we will accurately measure frailty, cognition (memory and brain function), activity and quality of life of these patients, and also in a group of 200 patients undergoing AVR. In this latter group undergoing an intervention, we will assess patients before and 6 months after surgery, but also test for delirium post-operatively. Frailty describes the loss of reserve that increases the risk of dependency or death, particularly in older individuals. Frailty testing is increasingly recognised in older populations, but the optimum assessment tool has not been established. We will compare different methods of frailty measurement.
Together, we will use these results to assess whether troponin may be used to monitor requirement for intervention in aortic stenosis, and identify which patient factors influence outcomes following surgery. We envision that this will improve assessment of aortic stenosis patients in the future.
REC name
South East Scotland REC 02
REC reference
14/SS/1110
Date of REC Opinion
6 Jan 2015
REC opinion
Further Information Favourable Opinion