Targeting cardiovascular events to improve patient outcomes after sepsis

摘要/项目总结 我们提出“靶向心血管事件以改善脓毒症后患者结局”研究， 通过发现新的，潜在的， 脓毒症后心血管事件的可改变的危险因素。脓毒症是一种危及生命的，失调的 对感染的反应和导致美国住院的最常见疾病，影响~1 美国人每年。心血管并发症是发病的最常见原因之一， 败血症后住院和死亡。大约三分之一的脓毒症幸存者因心血管疾病住院 脓毒症后一年内发生的事件。脓毒症后心血管并发症很常见，但危险因素 是不确定的，可能不同于传统的心脏风险因素。此外，处方模式的潜在 心脏保护药物尚不清楚，传统心血管风险调整的有效性 败血症后的治疗尚不确定。我们建议使用纵向的、颗粒状的电子健康记录数据 以解决涉及心血管并发症预测因素的知识缺口， 心血管风险调整的实践模式，以及为减少 在败血症后特别脆弱的时期，心血管风险。我们组建了一个专业团队 在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时， 最先进的方法我们的研究结果将为以下共同点提供新的见解： 败血症与心血管事件，并将告知目前的治疗策略，以及未来的行为， 研究减少心血管并发症和改善患者生活质量的新方法的随机试验 脓毒症后的结果

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.