STudy Of Risk Assessment To Reduce Complications In Patients Following Noncardiac SurgerY (STRATIFY)
Funder
National Health and Medical Research Council
Funding Amount
$436,000.00
Summary
Cardiac problems account for many complications in patients undergoing major non-cardiac surgery, and even apparently minor cardiac damage is a marker of high risk for subsequent adverse events. Unfortunately, while money and effort is expended on identifying patients at risk, the appropriate response to this risk is quite unclear. The performance of bypass surgery or balloon angioplasty in order to treat the underlying coronary disease of at-risk patients is used in other situations, and reduce ....Cardiac problems account for many complications in patients undergoing major non-cardiac surgery, and even apparently minor cardiac damage is a marker of high risk for subsequent adverse events. Unfortunately, while money and effort is expended on identifying patients at risk, the appropriate response to this risk is quite unclear. The performance of bypass surgery or balloon angioplasty in order to treat the underlying coronary disease of at-risk patients is used in other situations, and reduces longterm risk. However, in many patients undergoing major noncardiac surgery, this approach may be inappropriately aggressive, as these patients are often elderly, have other diseases that make heart operations more difficult and risky than usual, and in any case may have a reduced life expectancy from the disease necessitating the operation. As the most critical issue is to ensure that patients undergo their surgery uneventfully, an alternative is the use of intensive medical therapy to protect the heart. This multicentre study, based at Brisbane hospitals that perform large numbers of major operations, will follow up patients for complications, and outcome (including quality of life) will be assessed six months after the operation. We will address two important questions about the efficacy and cost of risk reduction strategies. First, in patients at higher levels of risk and with a positive stress test, could a combination of medical therapy designed to protect the heart be as effective as current approaches, which include the performance of bypass surgery or coronary balloon angioplasty? Second, in patients identified as being at some risk - but low risk - are drugs sufficiently effective to avoid the need for further testing to quantify risk? As the population continues to age, the numbers of at risk patients undergoing major surgery will increase, and answers to these questions will provide important information to guide their management.Read moreRead less
Optimising Accuracy And Cost-Effectiveness Of Screening For Pulmonary Arterial Hypertension In Scleroderma
Funder
National Health and Medical Research Council
Funding Amount
$375,403.00
Summary
Scleroderma is one of the most devastating diseases of the immune system. With features that affect every organ in the body, scleroderma shortens the average patient’s life by over three decades. Pulmonary arterial hypertension (PAH), a condition of increased resistance in the blood vessels of the lungs, is the major cause of death in this disease. The purpose of this project is to develop a new 'screening' model for the early detection of PAH in scleroderma, thereby enabling earlier initiation ....Scleroderma is one of the most devastating diseases of the immune system. With features that affect every organ in the body, scleroderma shortens the average patient’s life by over three decades. Pulmonary arterial hypertension (PAH), a condition of increased resistance in the blood vessels of the lungs, is the major cause of death in this disease. The purpose of this project is to develop a new 'screening' model for the early detection of PAH in scleroderma, thereby enabling earlier initiation of life-saving treatment.Read moreRead less
Early Detection And Treatment Of Rheumatic Heart Disease In High Risk Communities Using Community-led Approaches For Active Case Finding, Education And Engagement In Care
Funder
National Health and Medical Research Council
Funding Amount
$358,752.00
Summary
Rheumatic heart disease (RHD) affects many Aboriginal and Torres Strait Islander people. Early detection using an ultrasound of the heart (called an “echo”) can help children access treatment. Echo screening in remote communities needs active community participation and leadership in order to succeed. I will study new approaches to community-led echo screening to see if they are accurate enough, evaluate the impact of community involvement and describe outcomes for those diagnosed with RHD.
Cardiac Dysfunction In Advanced Liver Disease And After Liver Transplantation
Funder
National Health and Medical Research Council
Funding Amount
$128,224.00
Summary
Heart disease is the leading cause of early death after liver transplantation (LT). The scarcity of donor organs means that LT is a limited and valuable resource. We propose screening for heart disease before LT by CT scanning of heart arteries and heart function on stress testing to improve detection of coronary heart disease (CHD). Follow-up CT scans will also assess if LT causes progression of CHD. These studies will aid in development of personalised treatment strategies to improve outcomes.