Effects of Low-dose Esmolol on Myocardial Injury After Non-cardiac Surgery in Elderly Frail Patients

Launched by YONGTAO SUN · Nov 22, 2022

Keywords

ClinConnect Summary

This clinical trial is looking at how a medication called low-dose esmolol might help prevent heart injury in elderly patients who are frail and undergoing non-cardiac surgery. The study aims to understand the connection between frailty—a state of increased vulnerability due to aging—and heart injury after surgery. Researchers will also identify factors that could predict heart injury in these patients before they have surgery.

To be eligible for this trial, participants must be at least 65 years old, have a certain level of frailty, and be scheduled for non-cardiac surgery. However, patients with certain heart conditions or who are taking specific heart medications will not be included. If you join the study, you will receive either the medication or a placebo (a non-active treatment) and help researchers learn more about how to protect heart health in older adults during surgery. Your participation could contribute to important findings that may benefit future patients.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • 1. Age ≥ 65 years;
• • 2. ASA: ⅰ-ⅳ;
• • 3. Modified frailty index (mFI) ≥ 0.21;
• • 4. Patients undergoing non-cardiac surgery.
• Exclusion Criteria:
• • 1. Refuse to participate;
• • 2. Expected hospital stay \<3 days;
• • 3. Preoperative β-blocker therapy;
• • 4. History of myocardial infarction or coronary artery disease;
• • 5. Preoperative bradycardia (heart rate \[HR\] \< 50 bpm) or arrhythmia;
• • 6. Significant cardiac insufficiency (i.e., pulmonary artery pressure \>18 mm Hg, cardiac index ≤ 2.2 L/min/m 2);
• • 7. Severe valvular heart disease;
• • 8. Severe lung disease (e.g. asthma or chronic obstructive pulmonary disease);
• • 9. Patients with perioperative troponin elevation due to nonischemic causes (e.g., sepsis, pulmonary embolism, arrhythmia);
• • 10. The same patient can only be included once, regardless of whether the reason for the second operation is related to the first cause.
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