Targeting cardiovascular events to improve patient outcomes after sepsis

针对心血管事件以改善脓毒症后患者的预后

• 批准号: 9923730
• 负责人: Allan J. Walkey
• 金额: $ 71.06万
• 依托单位: BOSTON UNIVERSITY MEDICAL CAMPUS
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-07-15 至 2022-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9923730
• 关键词: Address; Adrenergic beta-Antagonists; Affect; Aftercare; American; American Heart Association; Angiotensin-Converting Enzyme Inhibitors; Anticoagulants; Antiplatelet Drugs; Atrial Fibrillation; Benefits and Risks; Biological Markers; Cardiac; Cardiovascular Diseases; Cardiovascular system; Cessation of life; Characteristics; Clinical; Clinical Trials; Collaborations; Data; Data Set; Diabetes Mellitus; Effectiveness; Electronic Health Record; Event; Future; Guidelines; Health; Heart Injuries; Heart failure; Hemorrhage; Hospitalization; Hospitals; Hyperlipidemia; Hypertension; Individual; Infection; Inflammation; Infrastructure; Injury to Kidney; Knowledge; Life; Methods; Modeling; Modification; Morbidity - disease rate; Myocardial Infarction; Outcome; Patient-Focused Outcomes; Patients; Pattern; Performance; Pharmaceutical Preparations; Physiological; Preventive; Preventive therapy; Recording of previous events; Risk; Risk Estimate; Risk Factors; Risk Reduction; Sepsis; Stroke; Structure; Survivors; Therapeutic; Thrombophilia; Time; Treatment Effectiveness; United States; Work; base; cardioprotection; cardiovascular risk factor; comorbidity; effectiveness evaluation; functional decline; high dimensionality; high risk; hospital readmission; improved; inhibitor/antagonist; innovation; insight; modifiable risk; mortality; novel; patient population; personalized approach; randomized trial; response; risk prediction model

ABSTRACT / PROJECT SUMMARY We propose the “Targeting cardiovascular events to improve patient outcomes after sepsis” study to identify opportunities to improve long-term patient outcomes after sepsis through the discovery of novel, potentially modifiable, risk factors for post-sepsis cardiovascular events. Sepsis is a life-threatening, dysregulated response to infection and the most common illness leading to hospitalization in the United States, affecting ~1 million Americans yearly. Cardiovascular complications are among the most common reasons for morbidity, re- hospitalization and death after sepsis. Approximately 1 in 3 sepsis survivors are hospitalized for cardiovascular events in the year following sepsis. Cardiovascular complications after sepsis are common, but the risk factors are undefined and likely differ from traditional cardiac risk factors. In addition, prescribing patterns of potentially cardio-protective medications are unclear and effectiveness of traditional cardiovascular risk-modifying treatments after sepsis are uncertain. We propose to use longitudinal, granular, electronic health record data across multiple centers to address knowledge gaps involving predictors of cardiovascular complications, practice patterns of cardiovascular risk modification, and effectiveness of therapies prescribed to reduce cardiovascular risk in the especially vulnerable period after sepsis. We have assembled a team with expertise in using longitudinal electronic health record data to study novel cardiovascular risk factors and sepsis with state-of-the-art methods. Results from our study will provide new insights into the common intersection of sepsis with cardiovascular events and will inform current therapeutic strategies, as well as the conduct of future randomized trials investigating novel methods to reduce cardiovascular complications and improve patient outcome after sepsis.

摘要/项目摘要 我们提出“针对心血管事件以改善败血症后患者的预后”研究来确定 通过发现新的、潜在的治疗方法，有机会改善脓毒症后患者的长期预后 败血症后心血管事件的可改变的危险因素。败血症是一种危及生命、失调的疾病 对感染的反应和导致美国住院的最常见疾病，影响〜1 每年百万美国人。心血管并发症是最常见的发病原因之一， 败血症后住院并死亡。大约三分之一的脓毒症幸存者因心血管疾病住院 败血症后一年内发生的事件。脓毒症后的心血管并发症很常见，但危险因素 未定义，可能与传统的心脏危险因素不同。此外，潜在的处方模式 心脏保护药物尚不清楚，传统心血管风险控制的有效性 脓毒症后的治疗尚不确定。我们建议使用纵向、精细、电子健康记录数据 跨多个中心解决涉及心血管并发症预测因素的知识差距， 心血管风险改变的实践模式，以及降低心血管风险的治疗的有效性 脓毒症后特别脆弱时期的心血管风险。我们组建了一支具有专业知识的团队 使用纵向电子健康记录数据研究新的心血管危险因素和脓毒症 最先进的方法。我们的研究结果将为我们提供关于共同交叉点的新见解 败血症与心血管事件的关系，并将为当前的治疗策略以及未来的治疗提供信息 随机试验研究减少心血管并发症和改善患者状况的新方法 败血症后的结果。