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MortalitY in caRdIAc surgery (MYRIAD): A randomizeD controlled trial of volatile anesthetics. Rationale and design.
- Source :
-
Contemporary clinical trials [Contemp Clin Trials] 2017 Aug; Vol. 59, pp. 38-43. Date of Electronic Publication: 2017 May 19. - Publication Year :
- 2017
-
Abstract
- Objective: There is initial evidence that the use of volatile anesthetics can reduce the postoperative release of cardiac troponin I, the need for inotropic support, and the number of patients requiring prolonged hospitalization following coronary artery bypass graft (CABG) surgery. Nevertheless, small randomized controlled trials have failed to demonstrate a survival advantage. Thus, whether volatile anesthetics improve the postoperative outcome of cardiac surgical patients remains uncertain. An adequately powered randomized controlled trial appears desirable.<br />Design: Single blinded, international, multicenter randomized controlled trial with 1:1 allocation ratio.<br />Setting: Tertiary and University hospitals.<br />Interventions: Patients (n=10,600) undergoing coronary artery bypass graft will be randomized to receive either volatile anesthetic as part of the anesthetic plan, or total intravenous anesthesia.<br />Measurements and Main Results: The primary end point of the study will be one-year mortality (any cause). Secondary endpoints will be 30-day mortality; 30-day death or non-fatal myocardial infarction (composite endpoint); cardiac mortality at 30day and at one year; incidence of hospital re-admission during the one year follow-up period and duration of intensive care unit, and hospital stay. The sample size is based on the hypothesis that volatile anesthetics will reduce 1-year unadjusted mortality from 3% to 2%, using a two-sided alpha error of 0.05, and a power of 0.9.<br />Conclusions: The trial will determine whether the simple intervention of adding a volatile anesthetic, an intervention that can be implemented by all anesthesiologists, can improve one-year survival in patients undergoing coronary artery bypass graft surgery.<br /> (Copyright © 2017 Elsevier Inc. All rights reserved.)
- Subjects :
- Adult
Coronary Artery Disease mortality
Female
Humans
Male
Outcome and Process Assessment, Health Care
Survival Analysis
Volatilization
Anesthesia, Cardiac Procedures adverse effects
Anesthesia, Cardiac Procedures methods
Anesthetics, Inhalation administration & dosage
Anesthetics, Inhalation chemistry
Coronary Artery Bypass adverse effects
Coronary Artery Bypass methods
Coronary Artery Bypass mortality
Coronary Artery Disease surgery
Postoperative Complications etiology
Postoperative Complications prevention & control
Subjects
Details
- Language :
- English
- ISSN :
- 1559-2030
- Volume :
- 59
- Database :
- MEDLINE
- Journal :
- Contemporary clinical trials
- Publication Type :
- Academic Journal
- Accession number :
- 28533194
- Full Text :
- https://doi.org/10.1016/j.cct.2017.05.011