Preoperative Cardiology Consultation and the Incidence of Major Adverse Cardiac Events（MACE）

NCT06884436 | Completed

• 1 other identifier: PLAGH-AOC-L05
• Study Type: observational
• Target: 22,000
• Locations: 1 country
• Sites: 1

Brief Summary

This cohort study aims to determine when preoperative cardiology consultation is needed to reduce the incidence of major adverse cardiac events (MACE) in elderly patients undergoing non-cardiac surgery. The study collected data on elderly patients with preoperative electrocardiogram (ECG) results who underwent non-cardiac surgery. It was conducted at the First Medical Center of the Chinese People's Liberation Army General Hospital from January 2015 to August 2019. MACE was defined as a composite event occurring within 30 days postoperatively, including acute myocardial infarction, unstable angina, heart failure, new-onset severe arrhythmias, non-fatal cardiac arrest, and cardiac death. Data were extracted using structured query language (SQL) and reviewed by three experienced clinicians. Preoperative cardiology consultation was considered as a mediating variable. By modeling, the confounding factors and risk factors for MACE were identified, and the impact of cardiology consultation as a mediating factor on the incidence of postoperative MACE was evaluated. Additionally, the study aimed to identify which categories of ECG findings necessitate cardiology consultation to reduce the incidence of adverse cardiac events, thereby optimizing the cardiology consultation process.

Conditions

Major Adverse Cardiac Events; Acute Myocardial Infarction (AMI); Cardiac Death, Sudden; Cardiac Arrest (CA); Arrhythmia, Cardiac; Heart Failure (HF); Unstable Angina (UA)

Keywords

Cardiology Consultation; Major Adverse Cardiac Events; Preoperative; elderly; electrocardiogram

Outcome Measures

Primary Outcomes (1)

• MACE

  The entire sample was divided into a development cohort and a validation cohort in a 7:3 ratio. Univariate and multivariate logistic regression analyses were conducted to identify risk predictors of MACE and to establish a nomogram with statistically significant predictors. The development cohort was used to construct the MACE prediction model, while the data from the validation cohort were used for validation. Preoperative cardiology consultation was considered as a mediating variable. By modeling, the confounding factors and risk factors for MACE were identified, and the impact of cardiology consultation as a mediating factor on the incidence of postoperative MACE was evaluated.

  within 30 days post-surgery

Study Arms (1)

Risk Predictors of Major Adverse Cardiac Events

Identify risk factors through the incidence of major adverse cardiac events occurring within 30 days post-surgery, and analyze the benefits to patients through the intervention of cardiology consultations.

Eligibility Criteria

• Age: 65 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Select elderly patients who underwent elective surgery at the First Medical Center of the PLA General Hospital from January 2015 to August 2019. All subjects will sign an informed consent form; patients who cannot sign the informed consent form will be provided with verbal informed consent.

You may qualify if:

• Age ≥ 65 years;
• Preoperative ECG results available.

You may not qualify if:

• Age \< 65 years;
• Accepted cardiac or neuro surgery;
• Second surgery within 30 days post-operation;
• Patient refused to follow up.

Sponsors & Collaborators

• Chinese PLA General Hospital: lead

Study Sites (1)

Department of Anesthesiology, The First Medical Center, Chinese PLA General Hospital

Beijing, China

Location

Related Publications (3)

• Beattie WS, Lalu M, Bocock M, Feng S, Wijeysundera DN, Nagele P, Fleisher LA, Kurz A, Biccard B, Leslie K, Howell S, Landoni G, Grocott H, Lamy A, Richards T, Myles P; StEP COMPAC Group; Patient Comfort; Clinical Indicators; Delirium Postoperative Cognitive Dysfunction Stroke; Cardiovascular; Data Extractors; Respiratory; Inflammation Sepsis; Acute Kidney Injury; Bleeding Complications Patient Blood Management; Healthcare Resource Utilisation; Patient-Centred Outcomes; Organ Failure and Survival; Cancer Surgery. Systematic review and consensus definitions for the Standardized Endpoints in Perioperative Medicine (StEP) initiative: cardiovascular outcomes. Br J Anaesth. 2021 Jan;126(1):56-66. doi: 10.1016/j.bja.2020.09.023. Epub 2020 Oct 20.

  PMID: 33092804 RESULT

• Smilowitz NR, Berger JS. Perioperative Cardiovascular Risk Assessment and Management for Noncardiac Surgery: A Review. JAMA. 2020 Jul 21;324(3):279-290. doi: 10.1001/jama.2020.7840.

  PMID: 32692391 RESULT

• Hao L, Xu X, Dupre ME, Guo A, Zhang X, Qiu L, Zhao Y, Gu D. Adequate access to healthcare and added life expectancy among older adults in China. BMC Geriatr. 2020 Apr 9;20(1):129. doi: 10.1186/s12877-020-01524-9.

  PMID: 32272883 RESULT

MeSH Terms

Conditions

Cardiovascular Diseases; Death, Sudden, Cardiac; Heart Arrest; Arrhythmias, Cardiac; Heart Failure; Angina, Unstable

Condition Hierarchy (Ancestors)

Heart Diseases; Death, Sudden; Death; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Angina Pectoris; Myocardial Ischemia; Vascular Diseases; Chest Pain; Pain; Neurologic Manifestations; Signs and Symptoms

Study Officials

• Jingsheng Lou, PhD & MD

  The First Medical Center, Chinese PLA General Hospital

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor

Study Record Dates

• First Submitted: March 13, 2025
• First Posted: March 19, 2025
• Study Start: January 1, 2015
• Primary Completion: August 31, 2019
• Study Completion: December 31, 2019
• Last Updated: March 28, 2025

Record last verified: 2025-03

Data Sharing

• IPD Sharing: Will not share

Locations

CN (1)