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1. A sub-study of the POISE-3 randomized trial examined effects of a perioperative hypotension-avoidance strategy versus a hypertension-avoidance strategy on the risk of acute kidney injury

Author

Garg, Amit X., Marcucci, Maura, Cuerden, Meaghan S., Sontrop, Jessica M., Painter, Thomas W., Lomivorotov, Vladimir, Sessler, Daniel I., Chan, Matthew T.V., Borges, Flavia K., Leslie, Kate, Duceppe, Emmanuelle, Parikh, Chirag R., Roshanov, Pavel, Martínez-Zapata, María José, Wang, Chew Yin, Xavier, Denis, Efremov, Sergey, Landoni, Giovanni, Kleinlugtenbelt, Ydo V., Szczeklik, Wojciech, Schmartz, Denis, Meyhoff, Christian S., Short, Timothy G., Amir, Mohammed, Torres, David, Wittmann, Maria, Patel, Ameen, Ruetzler, Kurt, Parlow, Joel L., Jayaram, Raja, Polanczyk, Carisi A., Fleischmann, Edith, Tandon, Vikas, Astrakov, Sergey V., Conen, David, Kei Wu, William Ka, Cheong, Chao Chia, Ayad, Sabry, Kirov, Mikhail, de Nadal, Miriam, Likhvantsev, Valery V., Paniagua, Pilar, Aguado, Hector J., Ofori, Sandra N., Vincent, Jessica, Copland, Ingrid, Balasubramanian, Kumar, Biccard, Bruce M., Srinathan, Sadeesh, Ismoilov, Samandar, Wang, Michael Ke, Kurz, Andrea, Belley-Cote, Emilie P., Bhatt, Keyur, Eikelboom, John, Gross, Peter, Lamy, Andre, McGillion, Michael, McIntyre, William, Richards, Toby, Spence, Jessica, Van Helder, Thomas, Whitlock, Richard, and Devereaux, P.J.

Published
2024
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2. Rationale and design of the PeriOperative ISchemic Evaluation-3 (POISE-3): a randomized controlled trial evaluating tranexamic acid and a strategy to minimize hypotension in noncardiac surgery

Author

Marcucci, Maura, Painter, Thomas W., Conen, David, Leslie, Kate, Lomivorotov, Vladimir V., Sessler, Daniel, Chan, Matthew T. V., Borges, Flavia K., Martínez Zapata, Maria J., Wang, C. Y., Xavier, Denis, Ofori, Sandra N., Landoni, Giovanni, Efremov, Sergey, Kleinlugtenbelt, Ydo V., Szczeklik, Wojciech, Schmartz, Denis, Garg, Amit X., Short, Timothy G., Wittmann, Maria, Meyhoff, Christian S., Amir, Mohammed, Torres, David, Patel, Ameen, Duceppe, Emmanuelle, Ruetzler, Kurtz, Parlow, Joel L., Tandon, Vikas, Wang, Michael K., Fleischmann, Edith, Polanczyk, Carisi A., Jayaram, Raja, Astrakov, Sergey V., Rao, Mangala, VanHelder, Tomas, Wu, William K. K., Cheong, Chao Chia, Ayad, Sabry, Abubakirov, Marat, Kirov, Mikhail, Bhatt, Keyur, de Nadal, Miriam, Likhvantsev, Valery, Iglesisas, Pilar Paniagua, Aguado, Hector J., McGillion, Michael, Lamy, Andre, Whitlock, Richard P., Roshanov, Pavel, Stillo, David, Copland, Ingrid, Vincent, Jessica, Balasubramanian, Kumar, Bangdiwala, Shrikant I., Biccard, Bruce, Kurz, Andrea, Srinathan, Sadeesh, Petit, Shirley, Eikelboom, John, Richards, Toby, Gross, Peter L., Alfonsi, Pascal, Guyatt, Gordon, Belley-Cote, Emily, Spence, Jessica, McIntyre, William, Yusuf, Salim, and Devereaux, P. J.

Published
2022
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4. Hypotension-Avoidance Versus Hypertension-Avoidance Strategies in Noncardiac Surgery: An International Randomized Controlled Trial

Author

Marcucci, Maura, Painter, Thomas W, Conen, David, Lomivorotov, Vladimir, Sessler, Daniel I, Chan, Matthew T V, Borges, Flavia K, Leslie, Kate, Duceppe, Emmanuelle, Martínez-Zapata, María José, Wang, Chew Yin, Xavier, Denis, Ofori, Sandra N, Wang, Michael Ke, Efremov, Sergey, Landoni, Giovanni, Kleinlugtenbelt, Ydo V, Szczeklik, Wojciech, Schmartz, Denis, Garg, Amit X, Short, Timothy G, Wittmann, Maria, Meyhoff, Christian S, Amir, Mohammed, Torres, David, Patel, Ameen, Ruetzler, Kurt, Parlow, Joel L, Tandon, Vikas, Fleischmann, Edith, Polanczyk, Carisi A, Lamy, Andre, Jayaram, Raja, Astrakov, Sergey V, Wu, William Ka Kei, Cheong, Chao Chia, Ayad, Sabry, Kirov, Mikhail, de Nadal, Miriam, Likhvantsev, Valery V, Paniagua, Pilar, Aguado, Hector J, Maheshwari, Kamal, Whitlock, Richard P, McGillion, Michael H, Vincent, Jessica, Copland, Ingrid, Balasubramanian, Kumar, Biccard, Bruce M, Srinathan, Sadeesh, van Lier, Felix, and Anesthesiology

Abstract

BACKGROUND: Among patients having noncardiac surgery, perioperative hemodynamic abnormalities are associated with vascular complications. Uncertainty remains about what intraoperative blood pressure to target and how to manage long-term antihypertensive medications perioperatively. OBJECTIVE: To compare the effects of a hypotension-avoidance and a hypertension-avoidance strategy on major vascular complications after noncardiac surgery. DESIGN: Partial factorial randomized trial of 2 perioperative blood pressure management strategies (reported here) and tranexamic acid versus placebo. (ClinicalTrials.gov: NCT03505723). SETTING: 110 hospitals in 22 countries. PATIENTS: 7490 patients having noncardiac surgery who were at risk for vascular complications and were receiving 1 or more long-term antihypertensive medications. INTERVENTION: In the hypotension-avoidance strategy group, the intraoperative mean arterial pressure target was 80 mm Hg or greater; before and for 2 days after surgery, renin-angiotensin-aldosterone system inhibitors were withheld and the other long-term antihypertensive medications were administered only for systolic blood pressures 130 mm Hg or greater, following an algorithm. In the hypertension-avoidance strategy group, the intraoperative mean arterial pressure target was 60 mm Hg or greater; all antihypertensive medications were continued before and after surgery. MEASUREMENTS: The primary outcome was a composite of vascular death and nonfatal myocardial injury after noncardiac surgery, stroke, and cardiac arrest at 30 days. Outcome adjudicators were masked to treatment assignment. RESULTS: The primary outcome occurred in 520 of 3742 patients (13.9%) in the hypotension-avoidance group and in 524 of 3748 patients (14.0%) in the hypertension-avoidance group (hazard ratio, 0.99 [95% CI, 0.88 to 1.12]; P = 0.92). Results were consistent for patients who used 1 or more than 1 antihypertensive medication in the long term. LIMITATION: Adherence to the assigned strategies was suboptimal; however, results were consistent across different adherence levels. CONCLUSION: In patients having noncardiac surgery, our hypotension-avoidance and hypertension-avoidance strategies resulted in a similar incidence of major vascular complications. PRIMARY FUNDING SOURCE: Canadian Institutes of Health Research, National Health and Medical Research Council (Australia), and Research Grant Council of Hong Kong.

Published
2023

5. Aspirin in Patients With Previous Percutaneous Coronary Intervention Undergoing Noncardiac Surgery

Author

Graham, Michelle M., Sessler, Daniel I., Parlow, Joel L., Biccard, Bruce M., Guyatt, Gordon, Leslie, Kate, Chan, Matthew T.V., Meyhoff, Christian S., Xavier, Denis, Sigamani, Alben, Kumar, Priya A., Mrkobrada, Marko, Cook, Deborah J., Tandon, Vikas, Alvarez-Garcia, Jesus, Villar, Juan Carlos, Painter, Thomas W., Landoni, Giovanni, Fleischmann, Edith, Lamy, Andre, Whitlock, Richard, Le Manach, Yannick, Aphang-Lam, Meylin, Cata, Juan P., Gao, Peggy, Terblanche, Nicolaas C.S., Ramana, Pamidimukkala V., Jamieson, Kim A., Bessissow, Amal, Mendoza, Gabriela R., Ramirez, Silvia, Diemunsch, Pierre A., Yusuf, Salim, and Devereaux, P.J.

Published
2018
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6. Tranexamic Acid in Patients Undergoing Noncardiac Surgery

Author

UCL - SSS/IREC/CARD - Pôle de recherche cardiovasculaire, Devereaux, P.J., Marcucci, Maura, Painter, Thomas W., Conen, David, Lomivorotov, Vladimir, Sessler, Daniel I., Chan, Matthew T.V., Borges, Flavia K., Martínez-Zapata, María J., Wang, Chew Yin, Xavier, Denis, Ofori, Sandra N., Wang, Michael K., Efremov, Sergey, Landoni, Giovanni, Kleinlugtenbelt, Ydo V., Szczeklik, Wojciech, Schmartz, Denis, Garg, Amit X., Short, Timothy G., Wittmann, Maria, Meyhoff, Christian S., Amir, Mohammed, Torres, David, Patel, Ameen, Duceppe, Emmanuelle, Ruetzler, Kurt, Parlow, Joel L., Tandon, Vikas, Fleischmann, Edith, Polanczyk, Carisi A., Lamy, Andre, Astrakov, Sergey V., Rao, Mangala, Wu, William K.K., Bhatt, Keyur, de Nadal, Miriam, Likhvantsev, Valery V., Paniagua, Pilar, Aguado, Hector J., Whitlock, Richard P., McGillion, Michael H., Prystajecky, Michael, Vincent, Jessica, Eikelboom, John, Copland, Ingrid, Balasubramanian, Kumar, Turan, Alparslan, Bangdiwala, Shrikant I., Stillo, David, Gross, Peter L., Cafaro, Teresa, Alfonsi, Pascal, Roshanov, Pavel S., Belley-Côté, Emilie P., Spence, Jessica, Richards, Toby, VanHelder, Tomas, McIntyre, William, Guyatt, Gordon, Yusuf, Salim, Leslie, Kate, UCL - SSS/IREC/CARD - Pôle de recherche cardiovasculaire, Devereaux, P.J., Marcucci, Maura, Painter, Thomas W., Conen, David, Lomivorotov, Vladimir, Sessler, Daniel I., Chan, Matthew T.V., Borges, Flavia K., Martínez-Zapata, María J., Wang, Chew Yin, Xavier, Denis, Ofori, Sandra N., Wang, Michael K., Efremov, Sergey, Landoni, Giovanni, Kleinlugtenbelt, Ydo V., Szczeklik, Wojciech, Schmartz, Denis, Garg, Amit X., Short, Timothy G., Wittmann, Maria, Meyhoff, Christian S., Amir, Mohammed, Torres, David, Patel, Ameen, Duceppe, Emmanuelle, Ruetzler, Kurt, Parlow, Joel L., Tandon, Vikas, Fleischmann, Edith, Polanczyk, Carisi A., Lamy, Andre, Astrakov, Sergey V., Rao, Mangala, Wu, William K.K., Bhatt, Keyur, de Nadal, Miriam, Likhvantsev, Valery V., Paniagua, Pilar, Aguado, Hector J., Whitlock, Richard P., McGillion, Michael H., Prystajecky, Michael, Vincent, Jessica, Eikelboom, John, Copland, Ingrid, Balasubramanian, Kumar, Turan, Alparslan, Bangdiwala, Shrikant I., Stillo, David, Gross, Peter L., Cafaro, Teresa, Alfonsi, Pascal, Roshanov, Pavel S., Belley-Côté, Emilie P., Spence, Jessica, Richards, Toby, VanHelder, Tomas, McIntyre, William, Guyatt, Gordon, Yusuf, Salim, and Leslie, Kate

Abstract

BACKGROUND Perioperative bleeding is common in patients undergoing noncardiac surgery. Tranexamic acid is an antifibrinolytic drug that may safely decrease such bleeding. METHODS We conducted a trial involving patients undergoing noncardiac surgery. Patients were randomly assigned to receive tranexamic acid (1-g intravenous bolus) or placebo at the start and end of surgery (reported here) and, with the use of a partial factorial design, a hypotension-avoidance or hypertension-avoidance strategy (not reported here). The primary efficacy outcome was life-threatening bleeding, major bleeding, or bleeding into a critical organ (composite bleeding outcome) at 30 days. The pri- mary safety outcome was myocardial injury after noncardiac surgery, nonhemor- rhagic stroke, peripheral arterial thrombosis, or symptomatic proximal venous thromboembolism (composite cardiovascular outcome) at 30 days. To establish the noninferiority of tranexamic acid to placebo for the composite cardiovascular out- come, the upper boundary of the one-sided 97.5% confidence interval for the hazard ratio had to be below 1.125, and the one-sided P value had to be less than 0.025. RESULTS A total of 9535 patients underwent randomization. A composite bleeding outcome event occurred in 433 of 4757 patients (9.1%) in the tranexamic acid group and in 561 of 4778 patients (11.7%) in the placebo group (hazard ratio, 0.76; 95% confi- dence interval [CI], 0.67 to 0.87; absolute difference, −2.6 percentage points; 95% CI, −3.8 to −1.4; two-sided P<0.001 for superiority). A composite cardiovascular outcome event occurred in 649 of 4581 patients (14.2%) in the tranexamic acid group and in 639 of 4601 patients (13.9%) in the placebo group (hazard ratio, 1.02; 95% CI, 0.92 to 1.14; upper boundary of the one-sided 97.5% CI, 1.14; absolute difference, 0.3 per- centage points; 95% CI, −1.1 to 1.7; one-sided P=0.04 for noninferiority). CONCLUSIONS Among patients undergoing noncardiac surgery, the incidence of the com

Published
2022

7. Rationale and design of the PeriOperative ISchemic Evaluation-3 (POISE-3):a randomized controlled trial evaluating tranexamic acid and a strategy to minimize hypotension in noncardiac surgery

Author

Marcucci, Maura, Painter, Thomas W., Conen, David, Leslie, Kate, Lomivorotov, Vladimir V., Sessler, Daniel, Chan, Matthew T.V., Borges, Flavia K., Martínez Zapata, Maria J., Wang, C. Y., Xavier, Denis, Ofori, Sandra N., Landoni, Giovanni, Efremov, Sergey, Kleinlugtenbelt, Ydo V., Szczeklik, Wojciech, Schmartz, Denis, Garg, Amit X., Short, Timothy G., Wittmann, Maria, Meyhoff, Christian S., Amir, Mohammed, Torres, David, Patel, Ameen, Duceppe, Emmanuelle, Ruetzler, Kurtz, Parlow, Joel L., Tandon, Vikas, Wang, Michael K., Fleischmann, Edith, Polanczyk, Carisi A., Jayaram, Raja, Astrakov, Sergey V., Rao, Mangala, VanHelder, Tomas, Wu, William K.K., Cheong, Chao Chia, Ayad, Sabry, Abubakirov, Marat, Kirov, Mikhail, Bhatt, Keyur, de Nadal, Miriam, Likhvantsev, Valery, Iglesisas, Pilar Paniagua, Aguado, Hector J., McGillion, Michael, Lamy, Andre, Whitlock, Richard P., Roshanov, Pavel, Stillo, David, Copland, Ingrid, Vincent, Jessica, Balasubramanian, Kumar, Bangdiwala, Shrikant I., Biccard, Bruce, Kurz, Andrea, Srinathan, Sadeesh, Petit, Shirley, Eikelboom, John, Richards, Toby, Gross, Peter L., Alfonsi, Pascal, Guyatt, Gordon, Belley-Cote, Emily, Spence, Jessica, McIntyre, William, Yusuf, Salim, Devereaux, P. J., Marcucci, Maura, Painter, Thomas W., Conen, David, Leslie, Kate, Lomivorotov, Vladimir V., Sessler, Daniel, Chan, Matthew T.V., Borges, Flavia K., Martínez Zapata, Maria J., Wang, C. Y., Xavier, Denis, Ofori, Sandra N., Landoni, Giovanni, Efremov, Sergey, Kleinlugtenbelt, Ydo V., Szczeklik, Wojciech, Schmartz, Denis, Garg, Amit X., Short, Timothy G., Wittmann, Maria, Meyhoff, Christian S., Amir, Mohammed, Torres, David, Patel, Ameen, Duceppe, Emmanuelle, Ruetzler, Kurtz, Parlow, Joel L., Tandon, Vikas, Wang, Michael K., Fleischmann, Edith, Polanczyk, Carisi A., Jayaram, Raja, Astrakov, Sergey V., Rao, Mangala, VanHelder, Tomas, Wu, William K.K., Cheong, Chao Chia, Ayad, Sabry, Abubakirov, Marat, Kirov, Mikhail, Bhatt, Keyur, de Nadal, Miriam, Likhvantsev, Valery, Iglesisas, Pilar Paniagua, Aguado, Hector J., McGillion, Michael, Lamy, Andre, Whitlock, Richard P., Roshanov, Pavel, Stillo, David, Copland, Ingrid, Vincent, Jessica, Balasubramanian, Kumar, Bangdiwala, Shrikant I., Biccard, Bruce, Kurz, Andrea, Srinathan, Sadeesh, Petit, Shirley, Eikelboom, John, Richards, Toby, Gross, Peter L., Alfonsi, Pascal, Guyatt, Gordon, Belley-Cote, Emily, Spence, Jessica, McIntyre, William, Yusuf, Salim, and Devereaux, P. J.

Abstract

Background: For patients undergoing noncardiac surgery, bleeding and hypotension are frequent and associated with increased mortality and cardiovascular complications. Tranexamic acid (TXA) is an antifibrinolytic agent with the potential to reduce surgical bleeding; however, there is uncertainty about its efficacy and safety in noncardiac surgery. Although usual perioperative care is commonly consistent with a hypertension-avoidance strategy (i.e., most patients continue their antihypertensive medications throughout the perioperative period and intraoperative mean arterial pressures of 60 mmHg are commonly accepted), a hypotension-avoidance strategy may improve perioperative outcomes. Methods: The PeriOperative Ischemic Evaluation (POISE)-3 Trial is a large international randomized controlled trial designed to determine if TXA is superior to placebo for the composite outcome of life-threatening, major, and critical organ bleeding, and non-inferior to placebo for the occurrence of major arterial and venous thrombotic events, at 30 days after randomization. Using a partial factorial design, POISE-3 will additionally determine the effect of a hypotension-avoidance strategy versus a hypertension-avoidance strategy on the risk of major cardiovascular events, at 30 days after randomization. The target sample size is 10,000 participants. Patients ≥45 years of age undergoing noncardiac surgery, with or at risk of cardiovascular and bleeding complications, are randomized to receive a TXA 1 g intravenous bolus or matching placebo at the start and at the end of surgery. Patients, health care providers, data collectors, outcome adjudicators, and investigators are blinded to the treatment allocation. Patients on ≥ 1 chronic antihypertensive medication are also randomized to either of the two blood pressure management strategies, which differ in the management of patient antihypertensive medications on the morning of surgery and on the first 2 days after surgery, and in the ta

Published
2022

8. Restrictive or Liberal Red-Cell Transfusion for Cardiac Surgery

Author

Mazer, David C., Whitlock, Richard P., Fergusson, Dean A., Hall, Judith, Belley-Cote, Emilie, Connolly, Katherine, Khanykin, Boris, Gregory, Alexander J., de Médicis, Étienne, McGuinness, Shay, Royse, Alistair, Carrier, François M., Young, Paul J., Villar, Juan C., Grocott, Hilary P., Seeberger, Manfred D., Fremes, Stephen, Lellouche, François, Syed, Summer, Byrne, Kelly, Bagshaw, Sean M., Hwang, Nian C., Mehta, Chirag, Painter, Thomas W., Royse, Colin, Verma, Subodh, Hare, Gregory M.T., Cohen, Ashley, Thorpe, Kevin E., Jüni, Peter, and Shehata, Nadine

Published
2017
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9. Tranexamic Acid in Patients Undergoing Noncardiac Surgery

Author

Devereaux, P.J., primary, Marcucci, Maura, additional, Painter, Thomas W., additional, Conen, David, additional, Lomivorotov, Vladimir, additional, Sessler, Daniel I., additional, Chan, Matthew T.V., additional, Borges, Flavia K., additional, Martínez-Zapata, María J., additional, Wang, Chew Yin, additional, Xavier, Denis, additional, Ofori, Sandra N., additional, Wang, Michael K., additional, Efremov, Sergey, additional, Landoni, Giovanni, additional, Kleinlugtenbelt, Ydo V., additional, Szczeklik, Wojciech, additional, Schmartz, Denis, additional, Garg, Amit X., additional, Short, Timothy G., additional, Wittmann, Maria, additional, Meyhoff, Christian S., additional, Amir, Mohammed, additional, Torres, David, additional, Patel, Ameen, additional, Duceppe, Emmanuelle, additional, Ruetzler, Kurt, additional, Parlow, Joel L., additional, Tandon, Vikas, additional, Fleischmann, Edith, additional, Polanczyk, Carisi A., additional, Lamy, Andre, additional, Astrakov, Sergey V., additional, Rao, Mangala, additional, Wu, William K.K., additional, Bhatt, Keyur, additional, de Nadal, Miriam, additional, Likhvantsev, Valery V., additional, Paniagua, Pilar, additional, Aguado, Hector J., additional, Whitlock, Richard P., additional, McGillion, Michael H., additional, Prystajecky, Michael, additional, Vincent, Jessica, additional, Eikelboom, John, additional, Copland, Ingrid, additional, Balasubramanian, Kumar, additional, Turan, Alparslan, additional, Bangdiwala, Shrikant I., additional, Stillo, David, additional, Gross, Peter L., additional, Cafaro, Teresa, additional, Alfonsi, Pascal, additional, Roshanov, Pavel S., additional, Belley-Côté, Emilie P., additional, Spence, Jessica, additional, Richards, Toby, additional, VanHelder, Tomas, additional, McIntyre, William, additional, Guyatt, Gordon, additional, Yusuf, Salim, additional, and Leslie, Kate, additional

Published
2022
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10. Additional file 9 of Rationale and design of the PeriOperative ISchemic Evaluation-3 (POISE-3): a randomized controlled trial evaluating tranexamic acid and a strategy to minimize hypotension in noncardiac surgery

Author

Marcucci, Maura, Painter, Thomas W., Conen, David, Leslie, Kate, Lomivorotov, Vladimir V., Sessler, Daniel, Chan, Matthew T. V., Borges, Flavia K., Mart��nez Zapata, Maria J., Wang, C. Y., Xavier, Denis, Ofori, Sandra N., Landoni, Giovanni, Efremov, Sergey, Kleinlugtenbelt, Ydo V., Szczeklik, Wojciech, Schmartz, Denis, Garg, Amit X., Short, Timothy G., Wittmann, Maria, Meyhoff, Christian S., Amir, Mohammed, Torres, David, Patel, Ameen, Duceppe, Emmanuelle, Ruetzler, Kurtz, Parlow, Joel L., Tandon, Vikas, Wang, Michael K., Fleischmann, Edith, Polanczyk, Carisi A., Jayaram, Raja, Astrakov, Sergey V., Rao, Mangala, VanHelder, Tomas, Wu, William K. K., Cheong, Chao Chia, Ayad, Sabry, Abubakirov, Marat, Kirov, Mikhail, Bhatt, Keyur, de Nadal, Miriam, Likhvantsev, Valery, Iglesisas, Pilar Paniagua, Aguado, Hector J., McGillion, Michael, Lamy, Andre, Whitlock, Richard P., Roshanov, Pavel, Stillo, David, Copland, Ingrid, Vincent, Jessica, Balasubramanian, Kumar, Bangdiwala, Shrikant I., Biccard, Bruce, Kurz, Andrea, Srinathan, Sadeesh, Petit, Shirley, Eikelboom, John, Richards, Toby, Gross, Peter L., Alfonsi, Pascal, Guyatt, Gordon, Belley-Cote, Emily, Spence, Jessica, McIntyre, William, Yusuf, Salim, and Devereaux, P. J.

Abstract

Additional file 9. POISE-3 informed consent form template (English).

Published
2022
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11. Additional file 7 of Rationale and design of the PeriOperative ISchemic Evaluation-3 (POISE-3): a randomized controlled trial evaluating tranexamic acid and a strategy to minimize hypotension in noncardiac surgery

Author

Marcucci, Maura, Painter, Thomas W., Conen, David, Leslie, Kate, Lomivorotov, Vladimir V., Sessler, Daniel, Chan, Matthew T. V., Borges, Flavia K., Mart��nez Zapata, Maria J., Wang, C. Y., Xavier, Denis, Ofori, Sandra N., Landoni, Giovanni, Efremov, Sergey, Kleinlugtenbelt, Ydo V., Szczeklik, Wojciech, Schmartz, Denis, Garg, Amit X., Short, Timothy G., Wittmann, Maria, Meyhoff, Christian S., Amir, Mohammed, Torres, David, Patel, Ameen, Duceppe, Emmanuelle, Ruetzler, Kurtz, Parlow, Joel L., Tandon, Vikas, Wang, Michael K., Fleischmann, Edith, Polanczyk, Carisi A., Jayaram, Raja, Astrakov, Sergey V., Rao, Mangala, VanHelder, Tomas, Wu, William K. K., Cheong, Chao Chia, Ayad, Sabry, Abubakirov, Marat, Kirov, Mikhail, Bhatt, Keyur, de Nadal, Miriam, Likhvantsev, Valery, Iglesisas, Pilar Paniagua, Aguado, Hector J., McGillion, Michael, Lamy, Andre, Whitlock, Richard P., Roshanov, Pavel, Stillo, David, Copland, Ingrid, Vincent, Jessica, Balasubramanian, Kumar, Bangdiwala, Shrikant I., Biccard, Bruce, Kurz, Andrea, Srinathan, Sadeesh, Petit, Shirley, Eikelboom, John, Richards, Toby, Gross, Peter L., Alfonsi, Pascal, Guyatt, Gordon, Belley-Cote, Emily, Spence, Jessica, McIntyre, William, Yusuf, Salim, and Devereaux, P. J.

Abstract

Additional file 7. POISE-3 interim analyses.

Published
2022
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12. Additional file 10 of Rationale and design of the PeriOperative ISchemic Evaluation-3 (POISE-3): a randomized controlled trial evaluating tranexamic acid and a strategy to minimize hypotension in noncardiac surgery

Author

Marcucci, Maura, Painter, Thomas W., Conen, David, Leslie, Kate, Lomivorotov, Vladimir V., Sessler, Daniel, Chan, Matthew T. V., Borges, Flavia K., Mart��nez Zapata, Maria J., Wang, C. Y., Xavier, Denis, Ofori, Sandra N., Landoni, Giovanni, Efremov, Sergey, Kleinlugtenbelt, Ydo V., Szczeklik, Wojciech, Schmartz, Denis, Garg, Amit X., Short, Timothy G., Wittmann, Maria, Meyhoff, Christian S., Amir, Mohammed, Torres, David, Patel, Ameen, Duceppe, Emmanuelle, Ruetzler, Kurtz, Parlow, Joel L., Tandon, Vikas, Wang, Michael K., Fleischmann, Edith, Polanczyk, Carisi A., Jayaram, Raja, Astrakov, Sergey V., Rao, Mangala, VanHelder, Tomas, Wu, William K. K., Cheong, Chao Chia, Ayad, Sabry, Abubakirov, Marat, Kirov, Mikhail, Bhatt, Keyur, de Nadal, Miriam, Likhvantsev, Valery, Iglesisas, Pilar Paniagua, Aguado, Hector J., McGillion, Michael, Lamy, Andre, Whitlock, Richard P., Roshanov, Pavel, Stillo, David, Copland, Ingrid, Vincent, Jessica, Balasubramanian, Kumar, Bangdiwala, Shrikant I., Biccard, Bruce, Kurz, Andrea, Srinathan, Sadeesh, Petit, Shirley, Eikelboom, John, Richards, Toby, Gross, Peter L., Alfonsi, Pascal, Guyatt, Gordon, Belley-Cote, Emily, Spence, Jessica, McIntyre, William, Yusuf, Salim, and Devereaux, P. J.

Subjects
ComputingMilieux_THECOMPUTINGPROFESSION, Data_FILES, GeneralLiterature_REFERENCE(e.g.,dictionaries,encyclopedias,glossaries)
Abstract

Additional file 10. List of investigators and committees.

Published
2022
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13. Additional file 8 of Rationale and design of the PeriOperative ISchemic Evaluation-3 (POISE-3): a randomized controlled trial evaluating tranexamic acid and a strategy to minimize hypotension in noncardiac surgery

Author

Marcucci, Maura, Painter, Thomas W., Conen, David, Leslie, Kate, Lomivorotov, Vladimir V., Sessler, Daniel, Chan, Matthew T. V., Borges, Flavia K., Mart��nez Zapata, Maria J., Wang, C. Y., Xavier, Denis, Ofori, Sandra N., Landoni, Giovanni, Efremov, Sergey, Kleinlugtenbelt, Ydo V., Szczeklik, Wojciech, Schmartz, Denis, Garg, Amit X., Short, Timothy G., Wittmann, Maria, Meyhoff, Christian S., Amir, Mohammed, Torres, David, Patel, Ameen, Duceppe, Emmanuelle, Ruetzler, Kurtz, Parlow, Joel L., Tandon, Vikas, Wang, Michael K., Fleischmann, Edith, Polanczyk, Carisi A., Jayaram, Raja, Astrakov, Sergey V., Rao, Mangala, VanHelder, Tomas, Wu, William K. K., Cheong, Chao Chia, Ayad, Sabry, Abubakirov, Marat, Kirov, Mikhail, Bhatt, Keyur, de Nadal, Miriam, Likhvantsev, Valery, Iglesisas, Pilar Paniagua, Aguado, Hector J., McGillion, Michael, Lamy, Andre, Whitlock, Richard P., Roshanov, Pavel, Stillo, David, Copland, Ingrid, Vincent, Jessica, Balasubramanian, Kumar, Bangdiwala, Shrikant I., Biccard, Bruce, Kurz, Andrea, Srinathan, Sadeesh, Petit, Shirley, Eikelboom, John, Richards, Toby, Gross, Peter L., Alfonsi, Pascal, Guyatt, Gordon, Belley-Cote, Emily, Spence, Jessica, McIntyre, William, Yusuf, Salim, and Devereaux, P. J.

Abstract

Additional file 8. POISE-3 organizational structure and oversight of trial conduct.

Published
2022
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14. Additional file 5 of Rationale and design of the PeriOperative ISchemic Evaluation-3 (POISE-3): a randomized controlled trial evaluating tranexamic acid and a strategy to minimize hypotension in noncardiac surgery

Author

Marcucci, Maura, Painter, Thomas W., Conen, David, Leslie, Kate, Lomivorotov, Vladimir V., Sessler, Daniel, Chan, Matthew T. V., Borges, Flavia K., Mart��nez Zapata, Maria J., Wang, C. Y., Xavier, Denis, Ofori, Sandra N., Landoni, Giovanni, Efremov, Sergey, Kleinlugtenbelt, Ydo V., Szczeklik, Wojciech, Schmartz, Denis, Garg, Amit X., Short, Timothy G., Wittmann, Maria, Meyhoff, Christian S., Amir, Mohammed, Torres, David, Patel, Ameen, Duceppe, Emmanuelle, Ruetzler, Kurtz, Parlow, Joel L., Tandon, Vikas, Wang, Michael K., Fleischmann, Edith, Polanczyk, Carisi A., Jayaram, Raja, Astrakov, Sergey V., Rao, Mangala, VanHelder, Tomas, Wu, William K. K., Cheong, Chao Chia, Ayad, Sabry, Abubakirov, Marat, Kirov, Mikhail, Bhatt, Keyur, de Nadal, Miriam, Likhvantsev, Valery, Iglesisas, Pilar Paniagua, Aguado, Hector J., McGillion, Michael, Lamy, Andre, Whitlock, Richard P., Roshanov, Pavel, Stillo, David, Copland, Ingrid, Vincent, Jessica, Balasubramanian, Kumar, Bangdiwala, Shrikant I., Biccard, Bruce, Kurz, Andrea, Srinathan, Sadeesh, Petit, Shirley, Eikelboom, John, Richards, Toby, Gross, Peter L., Alfonsi, Pascal, Guyatt, Gordon, Belley-Cote, Emily, Spence, Jessica, McIntyre, William, Yusuf, Salim, and Devereaux, P. J.

Abstract

Additional file 5. POISE-3 tertiary outcomes.

Published
2022
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15. Additional file 3 of Rationale and design of the PeriOperative ISchemic Evaluation-3 (POISE-3): a randomized controlled trial evaluating tranexamic acid and a strategy to minimize hypotension in noncardiac surgery

Author

Marcucci, Maura, Painter, Thomas W., Conen, David, Leslie, Kate, Lomivorotov, Vladimir V., Sessler, Daniel, Chan, Matthew T. V., Borges, Flavia K., Mart��nez Zapata, Maria J., Wang, C. Y., Xavier, Denis, Ofori, Sandra N., Landoni, Giovanni, Efremov, Sergey, Kleinlugtenbelt, Ydo V., Szczeklik, Wojciech, Schmartz, Denis, Garg, Amit X., Short, Timothy G., Wittmann, Maria, Meyhoff, Christian S., Amir, Mohammed, Torres, David, Patel, Ameen, Duceppe, Emmanuelle, Ruetzler, Kurtz, Parlow, Joel L., Tandon, Vikas, Wang, Michael K., Fleischmann, Edith, Polanczyk, Carisi A., Jayaram, Raja, Astrakov, Sergey V., Rao, Mangala, VanHelder, Tomas, Wu, William K. K., Cheong, Chao Chia, Ayad, Sabry, Abubakirov, Marat, Kirov, Mikhail, Bhatt, Keyur, de Nadal, Miriam, Likhvantsev, Valery, Iglesisas, Pilar Paniagua, Aguado, Hector J., McGillion, Michael, Lamy, Andre, Whitlock, Richard P., Roshanov, Pavel, Stillo, David, Copland, Ingrid, Vincent, Jessica, Balasubramanian, Kumar, Bangdiwala, Shrikant I., Biccard, Bruce, Kurz, Andrea, Srinathan, Sadeesh, Petit, Shirley, Eikelboom, John, Richards, Toby, Gross, Peter L., Alfonsi, Pascal, Guyatt, Gordon, Belley-Cote, Emily, Spence, Jessica, McIntyre, William, Yusuf, Salim, and Devereaux, P. J.

Abstract

Additional file 3. Rationale for POISE-3 study dosing regimen of tranexamic acid.

Published
2022
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16. Additional file 6 of Rationale and design of the PeriOperative ISchemic Evaluation-3 (POISE-3): a randomized controlled trial evaluating tranexamic acid and a strategy to minimize hypotension in noncardiac surgery

Author

Marcucci, Maura, Painter, Thomas W., Conen, David, Leslie, Kate, Lomivorotov, Vladimir V., Sessler, Daniel, Chan, Matthew T. V., Borges, Flavia K., Mart��nez Zapata, Maria J., Wang, C. Y., Xavier, Denis, Ofori, Sandra N., Landoni, Giovanni, Efremov, Sergey, Kleinlugtenbelt, Ydo V., Szczeklik, Wojciech, Schmartz, Denis, Garg, Amit X., Short, Timothy G., Wittmann, Maria, Meyhoff, Christian S., Amir, Mohammed, Torres, David, Patel, Ameen, Duceppe, Emmanuelle, Ruetzler, Kurtz, Parlow, Joel L., Tandon, Vikas, Wang, Michael K., Fleischmann, Edith, Polanczyk, Carisi A., Jayaram, Raja, Astrakov, Sergey V., Rao, Mangala, VanHelder, Tomas, Wu, William K. K., Cheong, Chao Chia, Ayad, Sabry, Abubakirov, Marat, Kirov, Mikhail, Bhatt, Keyur, de Nadal, Miriam, Likhvantsev, Valery, Iglesisas, Pilar Paniagua, Aguado, Hector J., McGillion, Michael, Lamy, Andre, Whitlock, Richard P., Roshanov, Pavel, Stillo, David, Copland, Ingrid, Vincent, Jessica, Balasubramanian, Kumar, Bangdiwala, Shrikant I., Biccard, Bruce, Kurz, Andrea, Srinathan, Sadeesh, Petit, Shirley, Eikelboom, John, Richards, Toby, Gross, Peter L., Alfonsi, Pascal, Guyatt, Gordon, Belley-Cote, Emily, Spence, Jessica, McIntyre, William, Yusuf, Salim, and Devereaux, P. J.

Abstract

Additional file 6. POISE-3 outcome definitions.

Published
2022
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17. Aspirin in Patients With Previous Percutaneous Coronary Intervention Undergoing Noncardiac Surgery

Author

Graham, Michelle M, Sessler, Daniel I, Parlow, Joel L, Biccard, Bruce M, Guyatt, Gordon, Leslie, Kate, Chan, Matthew T V, Meyhoff, Christian S., Xavier, Denis, Sigamani, Alben, Kumar, Priya A, Mrkobrada, Marko, Cook, Deborah J, Tandon, Vikas, Alvarez-Garcia, Jesus, Villar, Juan Carlos, Painter, Thomas W, Landoni, Giovanni, Fleischmann, Edith, Lamy, Andre, Whitlock, Richard, Le Manach, Yannick, Aphang-Lam, Meylin, Cata, Juan P, Gao, Peggy, Terblanche, Nicolaas C S, Ramana, Pamidimukkala V, Jamieson, Kim A, Bessissow, Amal, Mendoza, Gabriela R, Ramirez, Silvia, Diemunsch, Pierre A, Yusuf, Salim, Devereaux, P J, Graham, Michelle M, Sessler, Daniel I, Parlow, Joel L, Biccard, Bruce M, Guyatt, Gordon, Leslie, Kate, Chan, Matthew T V, Meyhoff, Christian S., Xavier, Denis, Sigamani, Alben, Kumar, Priya A, Mrkobrada, Marko, Cook, Deborah J, Tandon, Vikas, Alvarez-Garcia, Jesus, Villar, Juan Carlos, Painter, Thomas W, Landoni, Giovanni, Fleischmann, Edith, Lamy, Andre, Whitlock, Richard, Le Manach, Yannick, Aphang-Lam, Meylin, Cata, Juan P, Gao, Peggy, Terblanche, Nicolaas C S, Ramana, Pamidimukkala V, Jamieson, Kim A, Bessissow, Amal, Mendoza, Gabriela R, Ramirez, Silvia, Diemunsch, Pierre A, Yusuf, Salim, and Devereaux, P J

Abstract

Background: Uncertainty remains about the effects of aspirin in patients with prior percutaneous coronary intervention (PCI) having noncardiac surgery.Objective: To evaluate benefits and harms of perioperative aspirin in patients with prior PCI.Design: Nonprespecified subgroup analysis of a multicenter factorial trial. Computerized Internet randomization was done between 2010 and 2013. Patients, clinicians, data collectors, and outcome adjudicators were blinded to treatment assignment. (ClinicalTrials.gov: NCT01082874).Setting: 135 centers in 23 countries.Patients: Adults aged 45 years or older who had or were at risk for atherosclerotic disease and were having noncardiac surgery. Exclusions were placement of a bare-metal stent within 6 weeks, placement of a drug-eluting stent within 1 year, or receipt of nonstudy aspirin within 72 hours before surgery.Intervention: Aspirin therapy (overall trial, n = 4998; subgroup, n = 234) or placebo (overall trial, n = 5012; subgroup, n = 236) initiated within 4 hours before surgery and continued throughout the perioperative period. Of the 470 subgroup patients, 99.9% completed follow-up.Measurements: The 30-day primary outcome was death or nonfatal myocardial infarction; bleeding was a secondary outcome.Results: In patients with prior PCI, aspirin reduced the risk for the primary outcome (absolute risk reduction, 5.5% [95% CI, 0.4% to 10.5%]; hazard ratio [HR], 0.50 [CI, 0.26 to 0.95]; P for interaction = 0.036) and for myocardial infarction (absolute risk reduction, 5.9% [CI, 1.0% to 10.8%]; HR, 0.44 [CI, 0.22 to 0.87]; P for interaction = 0.021). The effect on the composite of major and life-threatening bleeding in patients with prior PCI was uncertain (absolute risk increase, 1.3% [CI, -2.6% to 5.2%]). In the overall population, aspirin increased the risk for major bleeding (absolute risk increase, 0.8% [CI, 0.1% to 1.6%]; HR, 1.22 [CI, 1.01 to 1.48]; P for interaction = 0.

Published
2018

18. Six-Month Outcomes after Restrictive or Liberal Transfusion for Cardiac Surgery

Author

Mazer, C. David, primary, Whitlock, Richard P., additional, Fergusson, Dean A., additional, Belley-Cote, Emilie, additional, Connolly, Katherine, additional, Khanykin, Boris, additional, Gregory, Alexander J., additional, de Médicis, Étienne, additional, Carrier, François M., additional, McGuinness, Shay, additional, Young, Paul J., additional, Byrne, Kelly, additional, Villar, Juan C., additional, Royse, Alistair, additional, Grocott, Hilary P., additional, Seeberger, Manfred D., additional, Mehta, Chirag, additional, Lellouche, François, additional, Hare, Gregory M.T., additional, Painter, Thomas W., additional, Fremes, Stephen, additional, Syed, Summer, additional, Bagshaw, Sean M., additional, Hwang, Nian-Chih, additional, Royse, Colin, additional, Hall, Judith, additional, Dai, David, additional, Mistry, Nikhil, additional, Thorpe, Kevin, additional, Verma, Subodh, additional, Jüni, Peter, additional, and Shehata, Nadine, additional

Published
2018
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19. Assessment of functional capacity before major non-cardiac surgery: an international, prospective cohort study

Author

Wijeysundera, Duminda N, primary, Pearse, Rupert M, additional, Shulman, Mark A, additional, Abbott, Tom E F, additional, Torres, Elizabeth, additional, Ambosta, Althea, additional, Croal, Bernard L, additional, Granton, John T, additional, Thorpe, Kevin E, additional, Grocott, Michael P W, additional, Farrington, Catherine, additional, Myles, Paul S, additional, Cuthbertson, Brian H, additional, Wallace, Sophie, additional, Thompson, Bruce, additional, Ellis, Mathew, additional, Borg, Brigette, additional, Kerridge, Ross K, additional, Douglas, Jeanene, additional, Brannan, John, additional, Pretto, Jeff, additional, Godsall, Guy, additional, Beauchamp, Nicola, additional, Allen, Sandra, additional, Kennedy, Ann, additional, Wright, Ewan, additional, Malherbe, Johan, additional, Ismail, Hilmy, additional, Riedel, Bernhard, additional, Melville, Andrew, additional, Sivakumar, Harry, additional, Murmane, Andrew, additional, Kenchington, Kay, additional, Kirabiyik, Yesim, additional, Gurunathan, Usha, additional, Stonell, Chris, additional, Brunello, Kate, additional, Steele, Katherine, additional, Tronstad, Oystein, additional, Masel, Philip, additional, Dent, Annette, additional, Smith, Emma, additional, Bodger, Alanna, additional, Abolfathi, Miriam, additional, Sivalingam, Pal, additional, Hall, Adrian, additional, Painter, Thomas W, additional, Macklin, Simon, additional, Elliott, Adrian, additional, Carrera, Anna Maria, additional, Terblanche, Nico CS, additional, Pitt, Simon, additional, Samuel, Joanne, additional, Wilde, Chris, additional, Leslie, Kate, additional, MacCormick, Andrew, additional, Bramley, David, additional, Southcott, Anne Marie, additional, Grant, John, additional, Taylor, Hugh, additional, Bates, Samantha, additional, Towns, Miriam, additional, Tippett, Anna, additional, Marshall, Fiona, additional, Mazer, C David, additional, Kunasingam, Janarthanee, additional, Yagnik, Anmol, additional, Crescini, Charmagne, additional, Yagnik, Sanjay, additional, McCartney, Colin JL, additional, Somascanthan, Priya, additional, Choi, Stephen, additional, Flores, Kathrina, additional, Au, Shelly, additional, Beattie, W Scott, additional, Karkouti, Keyvan, additional, Clarke, Hance A, additional, Jerath, Angela, additional, McCluskey, Stuart A, additional, Wasowicz, Marcin, additional, Day, Lauren, additional, Pazmino-Canizares, Janneth, additional, Oh, Paul, additional, Belliard, Rene, additional, Lee, Leanna, additional, Dobson, Karen, additional, Chan, Vincent, additional, Brull, Richard, additional, Ami, Noam, additional, Stanbrook, Matthew, additional, Hagen, Katherine, additional, Campbell, Douglas, additional, Short, Timothy, additional, Van Der Westhuizen, Joreline, additional, Higgie, Kushlin, additional, Lindsay, Helen, additional, Jang, Ryan, additional, Wong, Chris, additional, McAllister, Davina, additional, Ali, Marlynn, additional, Kumar, Jonathan, additional, Waymouth, Ellen, additional, Kim, Chang Joon, additional, Dimech, Julian, additional, Lorimer, Michael, additional, Tai, Joyce, additional, Miller, Reuben, additional, Sara, Rachel, additional, Collingwood, Andrew, additional, Olliff, Sue, additional, Gabriel, Sharon, additional, Houston, Helen, additional, Dalley, Paul, additional, Hurford, Sally, additional, Hunt, Anna, additional, Andrews, Lynn, additional, Navarra, Leanlove, additional, Jason-Smith, Adelaide, additional, Thompson, Helen, additional, McMillan, Natalie, additional, Back, Geraldine, additional, Lum, Mark, additional, Martin, Daniel, additional, James, Sarah, additional, Filipe, Helder, additional, Pinto, Manuel, additional, Kynaston, Stephen, additional, Phull, Mandeep, additional, Beilstein, Christian, additional, Bodger, Pheobe, additional, Everingham, Kirsty, additional, Hu, Ying, additional, Niebrzegowska, Edyta, additional, Corriea, Carmen, additional, Creary, Thais, additional, Januszewska, Marta, additional, Ahmad, Tahania, additional, Whalley, Jan, additional, Haslop, Richard, additional, McNeil, Jane, additional, Brown, Alistair, additional, MacDonald, Neil, additional, Pakats, Mari Liis, additional, Greaves, Kathryn, additional, Jhanji, Shaman, additional, Raobaikady, Ravishanar, additional, Black, Ethel, additional, Rooms, Martin, additional, Lawrence, Helen, additional, Koutra, Maria, additional, Pirie, Katrina, additional, Gertsman, Michelle, additional, Jack, Sandy, additional, Celinski, Michael, additional, Levett, Denny, additional, Edwards, Mark, additional, Salmon, Karen, additional, Bolger, Clare, additional, Loughney, Lisa, additional, Seaward, Leanne, additional, Collins, Hannah, additional, Tyrell, Bryony, additional, Tantony, Natasha, additional, Golder, Kim, additional, Ackland, Gareth L, additional, Stephens, RCM, additional, Gallego-Paredes, Laura, additional, Reyes, Anna, additional, Gutierrez del Arroyo, Ana, additional, Raj, Ashok, additional, Lifford, Rhiannon, additional, Melo, Magda, additional, Mamdani, Muhammad, additional, Hillis, Graham, additional, and Wijeysundera, Harindra C, additional

Published
2018
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20. Aspirin in Patients With Previous Percutaneous Coronary Intervention Undergoing Noncardiac Surgery

Author

Graham, Michelle M., primary, Sessler, Daniel I., additional, Parlow, Joel L., additional, Biccard, Bruce M., additional, Guyatt, Gordon, additional, Leslie, Kate, additional, Chan, Matthew T.V., additional, Meyhoff, Christian S., additional, Xavier, Denis, additional, Sigamani, Alben, additional, Kumar, Priya A., additional, Mrkobrada, Marko, additional, Cook, Deborah J., additional, Tandon, Vikas, additional, Alvarez-Garcia, Jesus, additional, Villar, Juan Carlos, additional, Painter, Thomas W., additional, Landoni, Giovanni, additional, Fleischmann, Edith, additional, Lamy, Andre, additional, Whitlock, Richard, additional, Le Manach, Yannick, additional, Aphang-Lam, Meylin, additional, Cata, Juan P., additional, Gao, Peggy, additional, Terblanche, Nicolaas C.S., additional, Ramana, Pamidimukkala V., additional, Jamieson, Kim A., additional, Bessissow, Amal, additional, Mendoza, Gabriela R., additional, Ramirez, Silvia, additional, Diemunsch, Pierre A., additional, Yusuf, Salim, additional, and Devereaux, P.J., additional

Published
2017
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22. Perioperative Aspirin for Prevention of Venous Thromboembolism

Author

Eikelboom, John W., primary, Kearon, Clive, additional, Guyatt, Gordon, additional, Sessler, Daniel I., additional, Yusuf, Salim, additional, Cook, Deborah, additional, Douketis, James, additional, Patel, Ameen, additional, Kurz, Andrea, additional, Allard, Rene, additional, Jones, Philip M., additional, Dennis, Rodolfo J., additional, Painter, Thomas W., additional, Bergese, Sergio D., additional, Leslie, Kate, additional, Wijeysundera, Duminda N., additional, Balasubramanian, Kumar, additional, Duceppe, Emmanuelle, additional, Miller, Scott, additional, Diedericks, Johan, additional, and Devereaux, P. J., additional

Published
2016
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24. Six-Month Outcomes after Restrictive or Liberal Transfusion for Cardiac Surgery

Author

Mazer, C. David, Whitlock, Richard P., Fergusson, Dean A., Belley-Cote, Emilie, Connolly, Katherine, Khanykin, Boris, Gregory, Alexander J., De Médicis, Étienne, Carrier, François M., McGuinness, Shay, Young, Paul J., Byrne, Kelly, Villar, Juan C., Royse, Alistair, Grocott, Hilary P., Seeberger, Manfred D., Mehta, Chirag, Lellouche, François, Hare, Gregory M.T., Painter, Thomas W., Fremes, Stephen, Syed, Summer, Bagshaw, Sean M., Hwang, Nian-Chih, Royse, Colin, Hall, Judith, Dai, David, Mistry, Nikhil, Thorpe, Kevin, Verma, Subodh, Jüni, Peter, and Shehata, Nadine

Subjects
610 Medicine & health, 3. Good health

25. Tranexamic Acid in Patients Undergoing Noncardiac Surgery

Author

P J, Devereaux, Maura, Marcucci, Thomas W, Painter, David, Conen, Vladimir, Lomivorotov, Daniel I, Sessler, Matthew T V, Chan, Flavia K, Borges, María J, Martínez-Zapata, Chew Yin, Wang, Denis, Xavier, Sandra N, Ofori, Michael K, Wang, Sergey, Efremov, Giovanni, Landoni, Ydo V, Kleinlugtenbelt, Wojciech, Szczeklik, Denis, Schmartz, Amit X, Garg, Timothy G, Short, Maria, Wittmann, Christian S, Meyhoff, Mohammed, Amir, David, Torres, Ameen, Patel, Emmanuelle, Duceppe, Kurt, Ruetzler, Joel L, Parlow, Vikas, Tandon, Edith, Fleischmann, Carisi A, Polanczyk, Andre, Lamy, Sergey V, Astrakov, Mangala, Rao, William K K, Wu, Keyur, Bhatt, Miriam, de Nadal, Valery V, Likhvantsev, Pilar, Paniagua, Hector J, Aguado, Richard P, Whitlock, Michael H, McGillion, Michael, Prystajecky, Jessica, Vincent, John, Eikelboom, Ingrid, Copland, Kumar, Balasubramanian, Alparslan, Turan, Shrikant I, Bangdiwala, David, Stillo, Peter L, Gross, Teresa, Cafaro, Pascal, Alfonsi, Pavel S, Roshanov, Emilie P, Belley-Côté, Jessica, Spence, Toby, Richards, Tomas, VanHelder, William, McIntyre, Gordon, Guyatt, Salim, Yusuf, Kate, Leslie, Erin, Hittesdorf, UCL - SSS/IREC/CARD - Pôle de recherche cardiovasculaire, Devereaux, P J, Marcucci, Maura, Painter, Thomas W, Conen, David, Lomivorotov, Vladimir, Sessler, Daniel I, Chan, Matthew T V, Borges, Flavia K, Martínez-Zapata, María J, Wang, Chew-Yin, Xavier, Deni, Ofori, Sandra N, Wang, Michael K, Efremov, Sergey, Landoni, Giovanni, Kleinlugtenbelt, Ydo V, Szczeklik, Wojciech, Schmartz, Deni, Garg, Amit X, Short, Timothy G, Wittmann, Maria, Meyhoff, Christian S, Amir, Mohammed, Torres, David, Patel, Ameen, Duceppe, Emmanuelle, Ruetzler, Kurt, Parlow, Joel L, Tandon, Vika, Fleischmann, Edith, Polanczyk, Carisi A, Lamy, Andre, Astrakov, Sergey V, Rao, Mangala, Wu, William K K, Bhatt, Keyur, de Nadal, Miriam, Likhvantsev, Valery V, Paniagua, Pilar, Aguado, Hector J, Whitlock, Richard P, Mcgillion, Michael H, Prystajecky, Michael, Vincent, Jessica, Eikelboom, John, Copland, Ingrid, Balasubramanian, Kumar, Turan, Alparslan, Bangdiwala, Shrikant I, Stillo, David, Gross, Peter L, Cafaro, Teresa, Alfonsi, Pascal, Roshanov, Pavel S, Belley-Côté, Emilie P, Spence, Jessica, Richards, Toby, Vanhelder, Toma, Mcintyre, William, Guyatt, Gordon, Yusuf, Salim, Leslie, Kate, and Anesthesiology

Subjects
BLOOD-TRANSFUSION, HEMORRHAGE, Canada, Tranexamic Acid, MORTALITY, Surgical Procedures, Operative, BIMS, Humans, Hemorrhage, Thrombosis, General Medicine, Antifibrinolytic Agents
Abstract

BACKGROUND Perioperative bleeding is common in patients undergoing noncardiac surgery. Tranexamic acid is an antifibrinolytic drug that may safely decrease such bleeding. METHODS We conducted a trial involving patients undergoing noncardiac surgery. Patients were randomly assigned to receive tranexamic acid (1-g intravenous bolus) or placebo at the start and end of surgery (reported here) and, with the use of a partial factorial design, a hypotension-avoidance or hypertension-avoidance strategy (not reported here). The primary efficacy outcome was life-threatening bleeding, major bleeding, or bleeding into a critical organ (composite bleeding outcome) at 30 days. The pri- mary safety outcome was myocardial injury after noncardiac surgery, nonhemor- rhagic stroke, peripheral arterial thrombosis, or symptomatic proximal venous thromboembolism (composite cardiovascular outcome) at 30 days. To establish the noninferiority of tranexamic acid to placebo for the composite cardiovascular out- come, the upper boundary of the one-sided 97.5% confidence interval for the hazard ratio had to be below 1.125, and the one-sided P value had to be less than 0.025. RESULTS A total of 9535 patients underwent randomization. A composite bleeding outcome event occurred in 433 of 4757 patients (9.1%) in the tranexamic acid group and in 561 of 4778 patients (11.7%) in the placebo group (hazard ratio, 0.76; 95% confi- dence interval [CI], 0.67 to 0.87; absolute difference, −2.6 percentage points; 95% CI, −3.8 to −1.4; two-sided P

Published
2022

26. Aspirin in Patients With Previous Percutaneous Coronary Intervention Undergoing Noncardiac Surgery

Author

Yannick Le Manach, Bruce M Biccard, Alben Sigamani, Salim Yusuf, Matthew T. V. Chan, Thomas Painter, Philip J. Devereaux, Vikas Tandon, Joel L. Parlow, Juan P. Cata, Amal Bessissow, Kate Leslie, Edith Fleischmann, Andre Lamy, Gabriela R. Mendoza, Christian S. Meyhoff, Marko Mrkobrada, Jesús Álvarez-García, Peggy Gao, Kim A. Jamieson, Meylin Aphang-Lam, Daniel I. Sessler, Michelle M. Graham, Pierre Diemunsch, Giovanni Landoni, Juan Carlos Villar, Silvia Ramirez, Priya A. Kumar, Richard P. Whitlock, Gordon H. Guyatt, Nicolaas C.S. Terblanche, Pamidimukkala V. Ramana, Deborah J. Cook, Denis Xavier, Graham, Michelle M, Sessler, Daniel I, Parlow, Joel L, Biccard, Bruce M, Guyatt, Gordon, Leslie, Kate, Chan, Matthew T. V, Meyhoff, Christian S, Xavier, Deni, Sigamani, Alben, Kumar, Priya A, Mrkobrada, Marko, Cook, Deborah J, Tandon, Vika, Alvarez-Garcia, Jesu, Villar, Juan Carlo, Painter, Thomas W, Landoni, Giovanni, Fleischmann, Edith, Lamy, Andre, Whitlock, Richard, Le Manach, Yannick, Aphang-Lam, Meylin, Cata, Juan P, Gao, Peggy, Terblanche, Nicolaas C. S, Ramana, Pamidimukkala V, Jamieson, Kim A, Bessissow, Amal, Mendoza, Gabriela R, Ramirez, Silvia, Diemunsch, Pierre A, Yusuf, Salim, and Devereaux, P. J.

Subjects
Male, medicine.medical_treatment, Myocardial Infarction, 030204 cardiovascular system & hematology, law.invention, Percutaneous coronary intervention, 0302 clinical medicine, Postoperative Complications, Randomized controlled trial, law, 030212 general & internal medicine, Myocardial infarction, Hospital medicine, Stent implantation, Aspirin, Drugs, General Medicine, Middle Aged, 3. Good health, medicine.anatomical_structure, Treatment Outcome, Surgical Procedures, Operative, cardiovascular system, Platelet aggregation inhibitor, purl.org/pe-repo/ocde/ford#3.02.27 [https], Drug Therapy, Combination, Female, medicine.drug, medicine.medical_specialty, Hazard ratio, Hemorrhage, Clonidine, Drug Administration Schedule, 03 medical and health sciences, Percutaneous Coronary Intervention, Multicenter trial, Absolute risk reduction, Internal Medicine, medicine, Humans, cardiovascular diseases, Antihypertensive Agents, Aged, business.industry, medicine.disease, Surgery, Coronary arteries, Conventional PCI, business, Biomarkers, Platelet Aggregation Inhibitors
Abstract

Background: Uncertainty remains about the effects of aspirin in patients with prior percutaneous coronary intervention (PCI) having noncardiac surgery. Objective: To evaluate benefits and harms of perioperative aspirin in patients with prior PCI. Design: Nonprespecified subgroup analysis of a multicenter factorial trial. Computerized Internet randomization was done between 2010 and 2013. Patients, clinicians, data collectors, and outcome adjudicators were blinded to treatment assignment. (ClinicalTrials.gov: NCT01082874). Setting: 135 centers in 23 countries. Patients: Adults aged 45 years or older who had or were at risk for atherosclerotic disease and were having noncardiac surgery. Exclusions were placement of a bare-metal stent within 6 weeks, placement of a drug-eluting stent within 1 year, or receipt of nonstudy aspirin within 72 hours before surgery. Intervention: Aspirin therapy (overall trial, n = 4998; subgroup, n = 234) or placebo (overall trial, n = 5012; subgroup, n = 236) initiated within 4 hours before surgery and continued throughout the perioperative period. Of the 470 subgroup patients, 99.9% completed follow-up. Measurements: The 30-day primary outcome was death or nonfatal myocardial infarction; bleeding was a secondary outcome. Results: In patients with prior PCI, aspirin reduced the risk for the primary outcome (absolute risk reduction, 5.5% [95% CI, 0.4% to 10.5%]; hazard ratio [HR], 0.50 [CI, 0.26 to 0.95]; P for interaction = 0.036) and for myocardial infarction (absolute risk reduction, 5.9% [CI, 1.0% to 10.8%]; HR, 0.44 [CI, 0.22 to 0.87]; P for interaction = 0.021). The effect on the composite of major and life-threatening bleeding in patients with prior PCI was uncertain (absolute risk increase, 1.3% [CI, -2.6% to 5.2%]). In the overall population, aspirin increased the risk for major bleeding (absolute risk increase, 0.8% [CI, 0.1% to 1.6%]; HR, 1.22 [CI, 1.01 to 1.48]; P for interaction = 0.50). Limitation: Nonprespecified subgroup analysis with small sample. Conclusion: Perioperative aspirin may be more likely to benefit rather than harm patients with prior PCI.

Published
2018

27. Hypotension-Avoidance Versus Hypertension-Avoidance Strategies in Noncardiac Surgery : An International Randomized Controlled Trial.

Author

Marcucci M, Painter TW, Conen D, Lomivorotov V, Sessler DI, Chan MTV, Borges FK, Leslie K, Duceppe E, Martínez-Zapata MJ, Wang CY, Xavier D, Ofori SN, Wang MK, Efremov S, Landoni G, Kleinlugtenbelt YV, Szczeklik W, Schmartz D, Garg AX, Short TG, Wittmann M, Meyhoff CS, Amir M, Torres D, Patel A, Ruetzler K, Parlow JL, Tandon V, Fleischmann E, Polanczyk CA, Lamy A, Jayaram R, Astrakov SV, Wu WKK, Cheong CC, Ayad S, Kirov M, de Nadal M, Likhvantsev VV, Paniagua P, Aguado HJ, Maheshwari K, Whitlock RP, McGillion MH, Vincent J, Copland I, Balasubramanian K, Biccard BM, Srinathan S, Ismoilov S, Pettit S, Stillo D, Kurz A, Belley-Côté EP, Spence J, McIntyre WF, Bangdiwala SI, Guyatt G, Yusuf S, and Devereaux PJ

Subjects
Humans, Antihypertensive Agents therapeutic use, Postoperative Complications epidemiology, Canada, Hypotension etiology, Hypotension prevention & control, Hypertension drug therapy
Abstract

Background: Among patients having noncardiac surgery, perioperative hemodynamic abnormalities are associated with vascular complications. Uncertainty remains about what intraoperative blood pressure to target and how to manage long-term antihypertensive medications perioperatively., Objective: To compare the effects of a hypotension-avoidance and a hypertension-avoidance strategy on major vascular complications after noncardiac surgery., Design: Partial factorial randomized trial of 2 perioperative blood pressure management strategies (reported here) and tranexamic acid versus placebo. (ClinicalTrials.gov: NCT03505723)., Setting: 110 hospitals in 22 countries., Patients: 7490 patients having noncardiac surgery who were at risk for vascular complications and were receiving 1 or more long-term antihypertensive medications., Intervention: In the hypotension-avoidance strategy group, the intraoperative mean arterial pressure target was 80 mm Hg or greater; before and for 2 days after surgery, renin-angiotensin-aldosterone system inhibitors were withheld and the other long-term antihypertensive medications were administered only for systolic blood pressures 130 mm Hg or greater, following an algorithm. In the hypertension-avoidance strategy group, the intraoperative mean arterial pressure target was 60 mm Hg or greater; all antihypertensive medications were continued before and after surgery., Measurements: The primary outcome was a composite of vascular death and nonfatal myocardial injury after noncardiac surgery, stroke, and cardiac arrest at 30 days. Outcome adjudicators were masked to treatment assignment., Results: The primary outcome occurred in 520 of 3742 patients (13.9%) in the hypotension-avoidance group and in 524 of 3748 patients (14.0%) in the hypertension-avoidance group (hazard ratio, 0.99 [95% CI, 0.88 to 1.12]; P  = 0.92). Results were consistent for patients who used 1 or more than 1 antihypertensive medication in the long term., Limitation: Adherence to the assigned strategies was suboptimal; however, results were consistent across different adherence levels., Conclusion: In patients having noncardiac surgery, our hypotension-avoidance and hypertension-avoidance strategies resulted in a similar incidence of major vascular complications., Primary Funding Source: Canadian Institutes of Health Research, National Health and Medical Research Council (Australia), and Research Grant Council of Hong Kong., Competing Interests: Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M22-3157.

Published
2023
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