Prognostic Accuracy of Coronary CT and Dobutamine Stress Echocardiography in Patient Undergoing Non-cardiac Surgery

Study Overview
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Brief Summary
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This study aimed to compare dobutamine stress echocardiography (DES) with computed tomography coronary angiography (CTCA) in patients with undergoing intermediate to high risk noncardiac surgery.

Conditions
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Cardiac Complications of Care (& [Post Operative])

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Elective surgery Intermediate or high-risk noncardiac surgeries 1) intermediate risk surgery: intrathoracic, intraperitoneal, orthopedic,head and neck, and prostate 2) high risk surgery: vascular Revised cardiac risk index score ≥1 (more than one of the following criteria) 1) vascular surgery, intraperitoneal, intrathoracic surgery 2) history of ischemic heart disease 3) history of heart failure 4) history of cerebrovascular disease 5) diabetes with insulin treatment 6) chronic kidney disease (serum creatinine > 2.0 mg/dL) Exclusion Criteria: Need for emergency surgery Active cardiac conditions 1) recent (within 1 month) myocardial infarction 2) acute decompensated heart failure 3) severe valvular disease 4) fatal cardiac arrhythmia 5) acute pulmonary embolism 6) acute myocarditis Relative contraindications or immeasurable coronary stenosis of the CTCA

Ages Eligible for Study
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Minimum Age: 20 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| DSE<br>Patients, who underwent Dobutamine Stress Echocardiography (DSE) | |
| CTCA<br>Computed tomography coronary angiography is going to perform with a 64-slice system (Brilliance 64, Philips Healthcare, Best, the Netherlands). | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Diagnostic accuracy of DES vs. CTCA in the prediction of the postoperative hard cardiac events in patients undergoing intermediate to high risk noncardiac surgeries | Diagnostic performance includes sensitivity, specificity, positive and negative predictive values, and receiver operator curve area under the curve. Postoperative hard cardiac events were defined as cardiac death, non-fatal myocardial infarction. | 1 month | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Diagnostic accuracy of DES vs. CTCA in the prediction of the perioperative all cardiovascular events in patients undergoing intermediate to high risk noncardiac surgeries. | Perioperative all cardiovascular events were defined as cardiac death, non-fatal myocardial infarction, pulmonary edema, ventricular fibrillation, new onset atrial fibrillation with hemodynamic compromise, complete heart block, pulmonary embolism, and prophylactic revascularization. | 1 month | 
| Diagnostic accuracy of DES and/or CTCA compared to revised cardiac risk score (RCRI) alone. | Incremental diagnostic accuracy changes with DES and/or CTCA compared to RCRI alone. Incremental diagnostic accuracy includes the area under the curve comparison analysis, integrated discrimination improvement, and net reclassification improvement. | 1 month | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Dobutamine Stress Echocardiography, Computed tomography coronary angiography