TY - JOUR
T1 - Outcomes in patients with chronic heart failure undergoing non-cardiac surgery
T2 - a secondary analysis of the METREPAIR international cohort study*
AU - Kirkopoulos, Anna
AU - M'Pembele, René
AU - Roth, Sebastian
AU - Stroda, Alexandra
AU - Larmann, Jan
AU - Gillmann, Hans-Joerg
AU - Kotfis, Katarzyna
AU - Ganter, Michael T.
AU - Bolliger, Daniel
AU - Filipovic, Miodrag
AU - Guzzetti, Luca
AU - Mauermann, Eckhard
AU - Ionescu, Daniela
AU - Spadaro, Savino
AU - Szczeklik, Wojciech
AU - de Hert, Stefan
AU - Beck-Schimmer, Beatrice
AU - Howell, Simon J.
AU - Lurati Buse, Giovanna A.
AU - METREPAIR Investigators
AU - Matute, Purificación
AU - Turhan, Sanem Cakar
AU - van Waes, Judith
AU - Lagarto, Filipa
AU - Theodoraki, Kassiani
AU - Gupta, Anil
AU - Ovezov, Alexey
AU - Kuzmanovska, Biljana
AU - Barisin, Stjepan
AU - Poredos, Peter
AU - Arabadzhieva, Daniela
AU - Unic-Stojanovic, Dragana
AU - Fleischmann, Edith
AU - Meistelman, Claude
AU - Buggy, Donal J.
AU - Calleja, Paul
AU - Roth, Antigona Hasani Sebastian
AU - M'Pembele, René
AU - Nienhaus, Johannes
AU - Stroda, Alexandra
AU - Tenge, Theresa
AU - Kirkopoulos, Anna
AU - Huhn, Ragnar
AU - Kindgen-Milles, Detlef
AU - Schultze, Cornelia
AU - Verbarg, Nele
AU - Gehrke, Christian
AU - Klemann, Anna Katharina
AU - Hagebölling, Friederike
AU - Gillmann, Hans-J. rg
AU - Albrecht, Svenja
AU - Stroeder, Jakob
AU - Schubert, Ann-Kristin
AU - Wulf, Hinnerk
AU - Espeter, Florian
AU - Russe, Benedikt
AU - Larmann, Jan
AU - Weigand, Markus A.
AU - Bergmann, Lars
AU - Unterberg, Matthias
AU - Bischoff, Petra
AU - Pirzer, Raphael
AU - Rach, Patric Rene
AU - Ott, Klaus
AU - Zarbock, Alexander
AU - Kowark, Ana
AU - Neumann, Claudia
AU - Marchand, Bahareh
AU - Sponholz, Christoph
AU - Rueffert, Henrik
AU - Kramer, Mira
AU - Lindau, Simone
AU - Meybohm, Patrick
AU - Zacharowski, Kai
AU - Schmidt, G. tz
AU - Koch, Christian
AU - Carollo, Melissa
AU - Novazzi, Cecilia
AU - Toso, Fiorenza
AU - Bacuzzi, Alessandro
AU - Guzzetti, Luca
AU - Ragazzi, Riccardo
AU - Volta, Carlo Alberto
AU - de Giorgi, Francesco
AU - Bacer, Barbara
AU - Federico, Antonio
AU - Chiumello, Davide
AU - Vetrugno, Luigi
AU - Castella, Alberto
AU - Tesoro, Simonetta
AU - Cotoia, Antonella
AU - Bignami, Elena
AU - Bellissima, Agrippino
AU - Cortegiani, Andrea
AU - Crisman, Marco
AU - Toninelli, Arturo
AU - Piazza, Ornella
AU - Mirabella, Lucia
AU - Bossolasco, Matteo
AU - Bona, Francesco
AU - Perdomo, Juan Manuel
AU - Coca-Martinez, Miquel
AU - Carramiñana, Albert
AU - Servén, Marta Giné
AU - González, Astrid Batalla
AU - Sánchez, José Maria Gil
AU - Becerra-Bolaños, Ángel
AU - Rodríguez-Pérez, Aurelio
AU - Soler, Anna Artigas
AU - Basso, Morena
AU - Font, Anna Peig
AU - Vernetta, Diana
AU - Santos, Julia Hernando
AU - Muñoz, Enrique Alday
AU - Olivares, Mercedes Cabellos
AU - Marco, Gregorio
AU - Lopez, Maria Bermudez
AU - Barrio, Javier
AU - Forés, María Isabel
AU - Boix, Estefanía
AU - Ayuso, Mercedes
AU - Petre, Bogdan Sorel
AU - Oprea, Ioana Sorina
AU - Latiș, Mihai Dan
AU - Corneci, Dan
AU - Margarit, Simona
AU - Vasian, Horatiu
AU - Tomescu, Dana
AU - Cîndea, Iulia
AU - Dirzu, Dan Sebastian
AU - Copotoiu, Sanda-Maria
AU - Moise, Alida
AU - Bubenek-Turconi, Serban
AU - Valeanu, Liana
AU - Wanner, Patrick Mark
AU - Djurdjevic, Mirjana
AU - Nuth, Sandra
AU - Filipovic, Miodrag
AU - Seeberger, Esther
AU - Goettel, Nicolai
AU - Kamber, Firmin
AU - Mauermann, Eckhard
AU - Chammartin, Frederique
AU - Ganter, Michael Thomas
AU - Gerber, Thomas Jan
AU - Schneebeli, Daniela
AU - Pregernig, Andreas
AU - Beck-Schimmer, Beatrice
AU - Grape, Sina
AU - Tomala, Simon
AU - Pinto, Bernardo Bollen
AU - Żukowski, Maciej
AU - Zegan-Barańska, Małgorzata
AU - Karolak, Igor
AU - Kotfis, Katarzyna
AU - Krzych, Lukasz
AU - Czajka, Szymon
AU - Studzińska, Dorota
AU - Kluzik, Anna
AU - Koszel, Tomasz
AU - Pabjańczyk, Izabela
AU - Gajdosz, Anna
AU - Erkoc, Suheyla Karadag
AU - Meco, Basak Ceyda
AU - Koltka, Ahmet Kemalettin
AU - Dincer, Muserref Beril
AU - Ekmekçi, Perihan
AU - Saracoglu, Kemal Tolga
AU - Solmaz, Filiz Alkaya
AU - Ozcelik, Menekse
AU - Arun, Oguzhan
AU - Dilmen, Ozlem Korkmaz
AU - Preckel, Benedikt
AU - Hollmann, Markus W.
AU - Hazen, Yannick
AU - de Boer, Hans Donald
AU - Epema, Anne
AU - Koopman, Seppe
AU - van Lier, Felix
AU - Pinto, Rita
AU - Carrão, André
AU - Ribeiro, Daniel
AU - Mourão, Joana
AU - Coelho, Miguel
AU - Losa, Nuno
AU - Santos, Nuno
AU - Cabral, Luis
AU - Afonso, Diana
AU - Zenha, S. rgio
AU - Ramos, Cristina
AU - Hipólito, Carla
AU - Vasilaki, Maria
AU - Andreeva, Antonia
AU - Zaimi, Donika
AU - Chalkias, Athanasios
AU - Spyraki, Maria
AU - Rekatsina, Martina
AU - Tsaousi, Georgia
AU - Short, Anthony
AU - Meier, Sonja
AU - Madhuri, Thumuluru Kavitha
AU - Latham, Scott
AU - Knock, James
AU - Drummond, Andrew
AU - Ramsden, Fiona
AU - Kubisz-Pudelko, null
AU - Walker, James
AU - Moppett, Iain
AU - White, Louise
AU - Howell, Simon J.
AU - Jackson, Matthew
AU - Reschreiter, Henrik
AU - Innes, Richard
AU - Chew, Michelle
AU - Kalman, Sigridur
AU - Wallden, Jakob
AU - Schening, Anna
AU - Jonikaite, Lina
AU - Enlund, Anna
AU - de Baerdemaeker, Luc
AU - Morrison, Stuart
AU - Rex, Steffen
AU - Alexis, Alexandros
AU - Khoronenko, Viktoria E.
AU - Belskii, Vladislav
AU - Kaznacheeva, Kseniya
AU - Gritsan, Alexey
AU - Malinovska-Nikolovska, Liljana
AU - Golubović, Mladjan
AU - Kotzinger, Oskar
AU - Deserts, Marc Danguy Des
AU - Ducrocq, Nicolas
AU - Bonnet, Jean François
AU - Cusack, Barbara
AU - Hasani, Antigona
AU - Nallbani, Rajmonda
AU - Daamen, Sylvia
AU - Plichon, Benoit
AU - Harlet, Pierre
AU - Farsi, Slama
AU - Sepehr, Saman Homayun
AU - Espinosa, David
N1 - Publisher Copyright:
© 2025 The Author(s). Anaesthesia published by John Wiley & Sons Ltd on behalf of Association of Anaesthetists.
PY - 2025/8
Y1 - 2025/8
N2 - Introduction: Heart failure is a frequent comorbidity in patients undergoing non-cardiac surgery and an acknowledged risk factor for postoperative mortality. The associations between stable chronic heart failure and postoperative outcomes have not been explored extensively. The aim of this study was to determine associations between stable chronic heart failure and its peri-operative management and postoperative outcomes after major non-cardiac surgery. Methods: This is a secondary analysis of MET-REPAIR, an international prospective cohort study including patients undergoing non-cardiac surgery aged ≥ 45 y with increased cardiovascular risk. Main exposures were stable chronic heart failure and availability of a pre-operative transthoracic echocardiogram. The primary endpoint was the incidence of postoperative major adverse cardiovascular events at 30 days. Secondary endpoints included 30-day mortality and severe in-hospital complications. Multivariable logistic regression models were calculated. Results: Of 15,158 included patients, 3880 (25.6%) fulfilled the diagnostic criteria for stable chronic heart failure, of whom 1397 (36%) were female. Chronic heart failure was associated with increased risk of postoperative 30-day major adverse cardiovascular events (OR 2.04, 95%CI 1.59–2.60), 30-day mortality (OR 1.50, 95%CI 1.17–1.92) and in-hospital complications (OR 1.47, 95%CI 1.30–1.66). Transthoracic echocardiography was performed in 1267 (32.7%) patients with heart failure; 146 (11.5%) patients with heart failure presented with a left ventricular ejection fraction < 40%. Reduced ejection fraction was associated with major adverse cardiovascular events (OR 2.0, 95%CI 1.01–3.81). Discussion: Stable chronic heart failure is independently associated with major adverse cardiovascular events, mortality and severe postoperative complications when measured 30 days after non-cardiac surgery.
AB - Introduction: Heart failure is a frequent comorbidity in patients undergoing non-cardiac surgery and an acknowledged risk factor for postoperative mortality. The associations between stable chronic heart failure and postoperative outcomes have not been explored extensively. The aim of this study was to determine associations between stable chronic heart failure and its peri-operative management and postoperative outcomes after major non-cardiac surgery. Methods: This is a secondary analysis of MET-REPAIR, an international prospective cohort study including patients undergoing non-cardiac surgery aged ≥ 45 y with increased cardiovascular risk. Main exposures were stable chronic heart failure and availability of a pre-operative transthoracic echocardiogram. The primary endpoint was the incidence of postoperative major adverse cardiovascular events at 30 days. Secondary endpoints included 30-day mortality and severe in-hospital complications. Multivariable logistic regression models were calculated. Results: Of 15,158 included patients, 3880 (25.6%) fulfilled the diagnostic criteria for stable chronic heart failure, of whom 1397 (36%) were female. Chronic heart failure was associated with increased risk of postoperative 30-day major adverse cardiovascular events (OR 2.04, 95%CI 1.59–2.60), 30-day mortality (OR 1.50, 95%CI 1.17–1.92) and in-hospital complications (OR 1.47, 95%CI 1.30–1.66). Transthoracic echocardiography was performed in 1267 (32.7%) patients with heart failure; 146 (11.5%) patients with heart failure presented with a left ventricular ejection fraction < 40%. Reduced ejection fraction was associated with major adverse cardiovascular events (OR 2.0, 95%CI 1.01–3.81). Discussion: Stable chronic heart failure is independently associated with major adverse cardiovascular events, mortality and severe postoperative complications when measured 30 days after non-cardiac surgery.
KW - cardiovascular risk
KW - guideline adherence
KW - mortality
KW - postoperative complications
UR - https://www.scopus.com/pages/publications/105002708461
U2 - 10.1111/anae.16607
DO - 10.1111/anae.16607
M3 - Article
C2 - 40230320
SN - 0003-2409
VL - 80
SP - 927
EP - 934
JO - Anaesthesia
JF - Anaesthesia
IS - 8
ER -