Identification de prédicteurs péri-opératoires pour améliorer l'estimation du risque cardiovasculaire chirurgical et déterminer leur impact sur la santé cardiovasculaire chez les patients subissant des chirurgies non-cardiaques

 

Amal Bessissow

Centre universitaire de santé McGill [CUSM]

 

Domaine : santé circulatoire et respiratoire

Programme Chercheurs-boursiers cliniciens - Junior 1

Concours 2019-2020

More and more people suffering from multiple medical problems and with poor exercise tolerance need surgery for urgent matters such as cancer removal. These patients are at higher risk of having cardiovascular complications after surgery such as heart attack, stroke, or death. My research program consists of finding better methods to identify high risk patients to ensure proper monitoring of these patients before and after surgery, and new strategies to reduce the risk of complications after surgery. My research program includes three projects. The first study is to assess the addition of six-minute walk test, a test that measures exercise tolerance, to a risk score to better predict which patient will develop cardiac complications after surgery. This study has already started and have recruited 550 out of 1000 patients. The second project consists of evaluating the impact of a personalized multimodal prehabilitation program on BNP value, a blood test that helps physicians predict postoperative cardiac complications. Higher the BNP value is the higher the risk of cardiac complications is.

This program allows patients to participate to a 4-week exercise program with nutritional and psychological support before the surgery. This study is looking at whether prehabilitation program will decrease the value of BNP and consequently, decrease the risk of cardiac complications after surgery. Finally, the last project is a to organize a gathering of medical experts to create recommendations on the administration of corticosteroids around the surgery, a drug that causes hormonal imbalance and complications such as  low blood pressure that can lead to death if not given at high enough quantity.