Key Highlights

KEY HIGHLIGHTS

Current systems for postoperative monitoring in surgical populations on hospital wards and at home are inadequate, with infrequent vital signs monitoring contributing to thousands of cases of undetected or delayed detection of hemodynamic compromise.
Remote automated monitoring (RAM), a subcomponent of telemedicine, is improving with technological advances that enable data integration and synthesis, as well as directed frontline nurse response, especially in surgical wards and at home.

MANAGE trial is an international, multicenter, randomized controlled trial with partial 2x2 factorial design involving 84 centers in 19 countries.
Participants aged ≥45 who underwent noncardiac surgery and sustained a myocardial infarction after noncardiac surgery (MINS) were included in the trial.
The study randomized 1754 patients to dabigatran or placebo and 556 patients were randomized to omeprazole or placebo.

POISE 2 was a blinded factorial randomized controlled trial. A total of 10,010 patients were recruited in 135 centers in 23 countries.
Participants were ≥45 years old, having non-cardiac surgery, and at risk of cardiovascular complications.
Participants were randomized to ASA versus placebo and clonidine versus placebo.

The VISION Study (Vascular Events in Noncardiac Surgery Patients Cohort Evaluation) was a prospective multicenter international cohort study. Main study objectives included evaluation of perioperative vascular complications in patients >45 years of age undergoing non-cardiac surgery. The study also assessed the value of routine high-sensitivity Troponin T (hsTnT) measurement for detection of myocardial injury after non-cardiac surgery (MINS) and adverse event prognostication.

The VISION Study (Vascular Events in Noncardiac Surgery Patients Cohort Evaluation) is a prospective multicenter international cohort study.
Main study objectives included evaluation of perioperative vascular complications in patients >45 years of age undergoing non-cardiac surgery. The study also assessed the value of routine Troponin (T) measurement for detection of myocardial injury after non-cardiac surgery (MINS) and adverse event prognostication.

The objectives were to determine if coronary computed tomographic angiography (CCTA) enhances prediction of perioperative risk in patients before non-cardiac surgery and to assess the preoperative coronary anatomy in patients who experience a myocardial infarction after non-cardiac surgery.

The authors conducted a systematic review and individual patient meta-analysis to examine the prognostic value of natriuretic peptides (NP) in patients undergoing non-cardiac surgery.
The study main objectives were to determine if adding preoperative NP measurement could enhance clinician’s ability to predict a composite of death and non-fatal myocardial infarction at 30 days and ≥180 days after non-cardiac surgery.

Examined a cohort of 667 consecutive major vascular surgery patients with an elevated postoperative Troponin I level to determine which patients received medical therapy as per the 2007 American College of Cardiology/American Heart Association recommendations for the medical management of patients with chronic stable angina.
The relationship of medical management consistent with guidelines with 12-month survival without a major cardiac event (ie, death, myocardial infarction, coronary revascularization, or pulmonary edema requiring hospitalization) was examined.

POISE-2 PCI substudy is part of a large international, multicenter, randomized controlled trial with 2x2 factorial design involving 135 centers in 23 countries.
POISE-2 PCI included 470 patients who underwent noncardiac surgery with prior PCI.
Participants were randomized to aspirin versus placebo.

Trials of beta blockers in patients undergoing non-cardiac surgery have historically reported conflicting results. POISE was a randomized controlled trial, involving 190 hospitals across 23 countries, designed to investigate the effects of perioperative beta blockers.