MedicalResearch.com Interview with:
Dr. PJ Devereaux MD, PhD, FRCP(C)
Director of the Division of Cardiolog
Scientific Leader of the Anesthesiology, Perioperative Medicine and
Surgical Research Group at the Population Health Research Institute
Professor and University Scholar in the Departments of Health Research Methods, Evidence, and Impact and Medicine
MedicalResearch.com: What is the background for this study?
Response: Although the majority of patients undergoing noncardiac surgery benefit from surgery and do well, even when a small proportion of these patients have a serious complication it represents a major population issue. A recent publication in JAMA Cardiology established that >5 million Americans age ≥45 years undergo major in-patient noncardiac surgery annually, and 1.3% of these patients die in the hospital. This means 65,000 of these patients die, and cardiovascular causes are a dominant cause.
MedicalResearch.com: What are the main findings?
Response: The “VISION” study enrolled nearly 22,000 patients aged 45 years or older from 23 hospitals in 13 countries and found that approximately 18 per cent of them sustained heart damage within 30 days of non-cardiac surgery and that, without enhanced monitoring, the vast majority – as many as 93 per cent – of these complications will go undetected, potentially until it’s too late to intervene.
MedicalResearch.com: What should readers take away from your report?
Response: Physicians need to monitor troponins in at-risk patients after noncardiac surgery to avoid missing the majority of prognostically important myocardial injuries.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: Trials evaluating new interventions to manage patients who suffer myocardial injury after noncardiac surgery.
MedicalResearch.com: Is there anything else you would like to add?
Response: VISION had over 60 funding sources. Mostly peer reviewed grants. We did, however, receive the troponin assays and some funding from Roche.
MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.
Writing Committee for the VISION Study Investigators. Association of Postoperative High-Sensitivity Troponin Levels With Myocardial Injury and 30-Day Mortality Among Patients Undergoing Noncardiac Surgery. JAMA. 2017;317(16):1642-1651. doi:10.1001/jama.2017.4360
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