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Open Access 01-12-2022 | Transthoracic Echocardiography | Study protocol

PRE-OPerative ECHOcardiograhy for prevention of cardiovascular events after non-cardiac surgery in intermediate- and high-risk patients: protocol for a low-interventional, mixed-cohort prospective study design (PREOP-ECHO)

Authors: Eun Kyoung Kim, Hong-Mi Choi, Eui-Young Choi, Hye Sun Lee, Goeun Park, Dong Woo Han, Sang-Eun Lee, Chan Seok Park, Ji-won Hwang, Jae Hyuk Choi, Mi-Na Kim, Hyung-Kwan Kim, Dae-Hee Kim, Sung-Hee Shin, Il Suk Sohn, Mi-Seung Shin, Jin Oh Na, Iksung Cho, Sun Hwa Lee, Yong Hyun Park, Tae-Ho Park, Kye Hun Kim, Goo-Young Cho, Hae Ok Jung, Dae-Gyun Park, Ji Yeon Hong, Duk-Hyun Kang

Published in: Trials | Issue 1/2022

Abstract

Background

Cardiac evaluation using transthoracic echocardiography before noncardiac surgery is common in real-world practice. However, evidence supporting preoperative echocardiography is lacking. This study aims to evaluate the additional benefit of preoperative echocardiography in predicting postoperative cardiovascular events (CVE) in noncardiac surgery.

Methods

This study is designed as a multicenter, prospective study to assess the utility of preoperative echocardiography in patients undergoing intermediate- or high-risk noncardiac surgery. This trial comprises two studies: (1) a randomized controlled trial (RCT) for patients undergoing intermediate-risk surgery with fewer than three clinical risk factors from the revised cardiac risk index (intermediate-risk group) and (2) a prospective cohort study for patients undergoing intermediate-risk surgery with three or more clinical risk factors, or who undergo high-risk surgery regardless of the number of clinical risk factors (high-risk group). We hypothesize that the use of preoperative echocardiography will reduce postoperative CVEs in patients undergoing intermediate- to high-risk surgery through discovery of and further intervention for unexpected cardiac abnormalities before elective surgery. A total of 2330 and 2184 patients will be enrolled in the two studies. The primary endpoint is a composite of all-cause death; aborted sudden cardiac arrest; type I acute myocardial infarction; clinically diagnosed unstable angina; stress-induced cardiomyopathy; lethal arrhythmia, such as sustained ventricular tachycardia or ventricular fibrillation; and/or newly diagnosed or acutely decompensated heart failure within 30 days after surgery.

Discussion

This study will be the first large-scale prospective study examining the benefit of preoperative echocardiography in predicting postoperative CVE. The PREOP-ECHO trial will help doctors identify patients at risk of postoperative CVE using echocardiography and thereby reduce postoperative CVEs.

Trial registration

The Clinical Research Information Service KCT0006279 for RCT and KCT0006280 for prospective cohort study. Registered on June 21, 2021.

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Title: PRE-OPerative ECHOcardiograhy for prevention of cardiovascular events after non-cardiac surgery in intermediate- and high-risk patients: protocol for a low-interventional, mixed-cohort prospective study design (PREOP-ECHO)
Authors: Eun Kyoung Kim
Hong-Mi Choi
Eui-Young Choi
Hye Sun Lee
Goeun Park
Dong Woo Han
Sang-Eun Lee
Chan Seok Park
Ji-won Hwang
Jae Hyuk Choi
Mi-Na Kim
Hyung-Kwan Kim
Dae-Hee Kim
Sung-Hee Shin
Il Suk Sohn
Mi-Seung Shin
Jin Oh Na
Iksung Cho
Sun Hwa Lee
Yong Hyun Park
Tae-Ho Park
Kye Hun Kim
Goo-Young Cho
Hae Ok Jung
Dae-Gyun Park
Ji Yeon Hong
Duk-Hyun Kang
Publication date: 01-12-2022
Publisher: BioMed Central
Keywords: Transthoracic Echocardiography
Echocardiography
Cardiomyopathy
Myocardial Infarction
Echocardiography
Published in: Trials / Issue 1/2022
Electronic ISSN: 1745-6215
DOI: https://doi.org/10.1186/s13063-022-06701-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

PRE-OPerative ECHOcardiograhy for prevention of cardiovascular events after non-cardiac surgery in intermediate- and high-risk patients: protocol for a low-interventional, mixed-cohort prospective study design (PREOP-ECHO)

Abstract

Background

Methods

Discussion

Trial registration

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Discussion

Trial registration

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