Vascular events In Surgery patIents cOhort evaluatioN (VISION)
Research type
Research Study
Full title
Vascular events In Surgery patIents cOhort evaluatioN (VISION)- Cardiac Surgery
IRAS ID
163405
Contact name
Nick Mills
Contact email
Sponsor organisation
NHS Lothian
Clinicaltrials.gov Identifier
Duration of Study in the UK
3 years, 0 months, 0 days
Research summary
The number of patients undergoing cardiac surgery is increasing as technologies in the treatment of heart disease continue to develop and improve. Frailer patients with complex health issues are undergoing major cardiac surgery such as bypass grafting or heart valve replacement. Making objective assessments of their risks of experiencing a complication from surgery is challenging, but simple assessments of frailty such as hand-grip strength have shown promise elsewhere. Direct heart damage is detectable through measurement of troponin, a protein released from injured heart muscle. This simple blood test is routinely used to diagnose heart attacks, but may reveal damage from other mechanisms, such as after surgery.
Heart damage following general surgery is common and independently predicts the risk of early death. In heart surgery, some injury is inevitable due to handling and instrumenting of the heart, and as such clinicians do not routinely measure troponin in this setting. However, this is despite evidence that higher levels of older blood markers of heart damage are associated with poorer outcomes after heart surgery. Preventable causes of heart injury are likely to be important to patient outcomes and have not been systematically evaluated. These could include failure of the bypass grafting or complications of surgery such as a heart attack. As one of 15 global sites participating in this observational cohort study, we will measure blood markers of heart injury before and after cardiac surgery, carefully relating these results to important complications such as stroke and heart attacks up to 1 year after surgery. We will systematically record patient risk factors and assessments before surgery including frailty. This will help to improve knowledge of major complications after cardiac surgery, and whether blood testing has a role in understanding the risks. We therefore aim to better understand the true patient impact of cardiac surgery.
REC name
South East Scotland REC 01
REC reference
15/SS/0026
Date of REC Opinion
15 Apr 2015
REC opinion
Further Information Favourable Opinion