Post Coronary Bypass Atrial Arrhythmic Prediction Rule

冠状动脉搭桥术后房性心律失常预测规则

• 批准号: 6422152
• 负责人: ROD S PASSMAN
• 金额: $ 12.29万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-09-30 至 2007-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6422152
• 关键词: arrhythmia; atrial fibrillation; cardiovascular disorder epidemiology; cardiovascular disorder risk; clinical research; coronary bypass; electrophysiology; human subject; method development; outcomes research; patient oriented research; postoperative complications; prognosis; statistics /biometry

DESCRIPTION (provided by applicant): The proposed study seeks to develop and validate a clinical prediction rule for post-coronary artery bypass grafting (CABG) atrial fibrillation and atrial flutter (AF). These arrhythmias occur in 20-40% of the 500,000 patients undergoing CABG, and increase the morbidity, cost, and length of stay associated with the procedure. Though several studies have suggested that prophylactic therapy with beta-adrenergic blockers decreases the risk of post-CABG AF, this efficacy has not been universally appreciated. As a result, several new prophylactic therapies have been introduced, though some with significant toxicities associated with them. It is therefore imperative to identify a priori those individuals most at risk of developing post-CABG AF, as well as those unlikely to develop this endpoint. In this manner, those individuals most at risk of developing post-CABG AF may be targeted for prophylactic therapy, while those in a low risk category may be spared the exposure to a potentially deleterious therapy from which they are less likely to derive benefit. Additionally, the identification of a high-risk subgroup would allow for the execution of smaller randomized controlled trials, and may provide insight into the etiology of post-CABG AF. The study is a retrospective cohort study designed to identify pre-, intra-, and post-operative variables which may be associated with post-CABG AF. From these results, a clinical prediction rule will be formulated. Validation of the prediction rule will then take place in a prospective cohort study using a different group of patients from which the rule was derived. This will allow for the assessment of both validity and generalizability. The candidate has committed himself to a career as an independent investigator, with an interest in the application of rigorous epidemiologic techniques to questions of importance in cardiac electrophysiology, his area of clinical expertise. This project will be an integral part of the candidate?s career development plan and his maturation as an epidemiologist, cardiac electrophysiologist, and clinical investigator.

描述（由申请人提供）： 拟议的研究旨在制定和验证临床预测规则 用于冠状动脉后旁路嫁接（CABG）房颤和心房 颤动（AF）。这些心律不齐发生在20-40％的500,000名患者中 经历CABG，增加发病率，成本和住院时间 与该过程相关联。尽管几项研究表明 β-肾上腺素能阻滞剂的预防治疗降低了 CABG AF后，这种功效尚未得到普遍赞赏。作为 结果，已经引入了几种新的预防疗法，尽管有些 与它们相关的显着毒性。因此，这是当务之急 确定那些最有风险发展CABG的人 AF，以及那些不太可能开发此终点的人。以这种方式，那些 可能有针对性的人可能会针对发展CABG后AF的人 预防性疗法，而低风险类别的人可能会保留 暴露于潜在有害疗法中，它们的可能性较小 获得利益。另外，鉴定高风险亚组 将允许执行较小的随机对照试验，并且可以 提供有关CABG后AF的病因的洞察力。 该研究是一项回顾性队列研究，旨在识别前，内， 可能与CABG后AF相关的术后变量。从 这些结果将制定临床预测规则。验证 然后，预测规则将在一项前瞻性队列研究中进行 该规则得出的不同组患者。这将允许 用于评估有效性和概括性。 候选人致力于独立的职业 研究人员，对严格流行病学的应用感兴趣 在心脏电生理学中重要的问题的技术，他的 临床专业知识领域。该项目将是该项目不可或缺的一部分 候选人的职业发展计划及其作为流行病学家的成熟， 心脏电生理学家和临床研究者。