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Cardiac and Thoracic Anesthesia
The cardiac anesthesia group's research effort is centered on the goal of making cardiac surgery safer for the patient. To this end we have been involved in a large multi-center international research organization. We are one of the principal sites of the Ischemia Research and Education Foundation. The Ischemia Research and Education Foundation (IREF) is a California based non-profit biomedical research organization dedicated to performing medical and scientific research in collaboration with the Government and for the pharmaceutical, medical device and CRO industries. The Foundation offers a highly integrated system of multidisciplinary professionals to enable rapid development of high quality clinical trials, study design, clinical monitoring, technology assessment, data collection, analysis and management.
As a member of McSPI (Multicenter Study of Perioperative Ischemia) we were a principal investigator in the Epi-I and Epi-II cardiac outcomes studies, two major epidemiological studies of patients undergoing cardiac surgery developed by IREF. Epi-II is a complex, global, multicenter study internally funded by IREF and the largest of its kind ever undertaken. For each of these comprehensive studies, IREF systematically collects and critically evaluates adverse outcomes, patient risk profiles and concomitant therapies. This data provides up-to-the-minute answers to questions relevant to clinical trial design.
Epidemiology I Summary
This study addressed two categories of questions - global and specific. Overall questions included determination of the nationwide incidence of adverse cardiovascular and cerebrovascular outcomes, predictors of adverse outcomes, therapies most effectively reversing an outcome, investigation of the impact of gender, race and age on surgical outcome and health-care resource allocation. Specific questions included evaluating efficacy of intraoperative techniques, such as warm blood cardioplegia, pulmonary artery catheterization, transesophageal echocardiography specific anti-ischemic cardiac and cerebral therapies, and mechanisms of perioperative ischemia, reperfusion injury and myocardial infarction. This study has been completed and resulted publications in the New England Journal, Circulation, and Stroke, which were coauthored by our NYU faculty.
Epidemiology II Summary
Epi-II is the largest epidemiological study of coronary artery bypass graft (CABG) and CABG/valve surgery ever undertaken. This multicenter study began in January 1997 and currently has over 61 participating sites worldwide. Using an IREF-designed Case Report Form, IREF's principal investigators are gathering the most comprehensive data to date of the natural history and pathophysiology of serious ischemic events occurring preoperatively in this patient population. This data can then be used to develop a better understanding of issues such as morbidity/mortality, hemodynamics, resource utilization/health economics, practice patterns and long-term outcomes, as well as answers to questions relevant to clinical trial design. We are principal investigators in this study as well.
We have also been involved with our own research involving the use of TEE to predict patients at risk for stroke during cardiac surgery. We have studied the use of TEE in guiding surgeons in techniques to avoid neurological complications from the dangerous atheromatous aorta, and we are internationally known for these efforts as well.
Clinical Trials
The cardiac anesthesia group is actively involved in clinical trials and is a member of several major academic clinical research organizations. We are members of GPRO (Global Perioperative Research Organization), a strategic collaboration between the (IARS) International Anesthesia Research Society and the (DCRI) Duke Clinical Research Institute.
We are dedicated to answering important medical questions and providing unbiased data and aiding in interpretation of these results. We have been associated with DCRI and GPRO for several years now, and will continue to collaborate in the future.
The Cardiac anesthesia group is also a member Gentiae Clinical Research Inc., which specializes in the design and management of knowledge-based clinical trials for cardiovascular drugs and devices in all phases of development. Through our comprehensive clinical services, access to EPI-1 and EPI-2 epidemiological databases, and affiliation with the McSPI Research Group, we aid them worldwide with multicenter clinical studies focused on phase 2 and 3 clinical trials.
Our involvement with various research organizations, as well as collaboration with the Division of Cardiac Surgery here at NYU, offers fellows and resident many research opportunities for all levels of junior clinical scientists.
