Post-Operative Biomarker-Guided Precision Medicine For Cardiovascular Risk

Description

The goal of this pilot study is to assess enrollment feasibility of a randomized trial of direct oral anticoagulant and high-intensity statin therapy versus usual care in patients with Myocardial Injury after Noncardiac Surgery (MINS). The primary aims of this study are to assess feasibility, study drug adherence, and optimize study design (entry criteria, study endpoints, sample size calculation, site selection) and recruitment strategies for the future multicenter randomized clinical trial studying biomarker-based care in post-operative patients at elevated cardiovascular (CV) risk.

Conditions

Myocardial Injury After Noncardiac Surgery

Study Overview

Study Details

Study overview

The goal of this pilot study is to assess enrollment feasibility of a randomized trial of direct oral anticoagulant and high-intensity statin therapy versus usual care in patients with Myocardial Injury after Noncardiac Surgery (MINS). The primary aims of this study are to assess feasibility, study drug adherence, and optimize study design (entry criteria, study endpoints, sample size calculation, site selection) and recruitment strategies for the future multicenter randomized clinical trial studying biomarker-based care in post-operative patients at elevated cardiovascular (CV) risk.

A Pilot Randomized Trial of Post-Operative Biomarker-Guided Precision Medicine With Rivaroxaban and Atorvastatin for Cardiovascular Risk-Reduction

Post-Operative Biomarker-Guided Precision Medicine For Cardiovascular Risk

Condition
Myocardial Injury After Noncardiac Surgery
Intervention / Treatment

-

Contacts and Locations

New York

NYU Langone Health, New York, New York, United States, 10016

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

For general information about clinical research, read Learn About Studies.

Eligibility Criteria

  • 1. Adults ≥45 years
  • 2. Underwent major non-cardiac surgery requiring ≥1 overnight inpatient stay in the prior 14 days
  • 3. Myocardial injury after noncardiac surgery, defined as a post-operative troponin ≥ 99th percentile upper reference limit \[URL\], with rise/fall \>20% indicative of acute myocardial injury.
  • 4. Ability to provide informed consent
  • 1. Expected survival \<6 months
  • 2. Hemorrhagic disorder
  • 3. Surgeon feels it is unsafe to initiate low-dose anticoagulation within 14 days of surgery
  • 4. Indication for oral anticoagulation at discharge
  • 5. Indication for dual antiplatelet therapy at discharge
  • 6. Patient already receiving or planned to receive moderate or high-intensity statin
  • 7. Contraindication to high-intensity statin
  • 8. Contraindication to rivaroxaban
  • 9. End stage kidney disease on hemodialysis
  • 10. Acute liver failure or decompensated cirrhosis
  • 11. Pregnancy

Ages Eligible for Study

45 Years to

Sexes Eligible for Study

ALL

Accepts Healthy Volunteers

No

Collaborators and Investigators

NYU Langone Health,

Nathaniel R. Smilowitz, MD, MS, PRINCIPAL_INVESTIGATOR, NYU Langone Health

Study Record Dates

2027-03-31