Evidence map›Paper›PMID 40230320›Full record

ArticleAnaesthesia2025

Outcomes in patients with chronic heart failure undergoing non-cardiac surgery: a secondary analysis of the METREPAIR international cohort study.

Anna Kirkopoulos, René M'Pembele, Sebastian Roth, Alexandra Stroda, Jan Larmann, Hans-Joerg Gillmann, Katarzyna Kotfis, Michael T Ganter, Daniel Bolliger, Miodrag Filipovic and 10 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Anaesthesia, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Article
  2. Review
  3. Observational
  4. Review
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors.

Anna KirkopoulosAnesthesiology Department, University Hospital Düsseldorf, Heinrich Heine University, Düsseldorf, Germany.
René M'PembeleAnesthesiology Department, University Hospital Düsseldorf, Heinrich Heine University, Düsseldorf, Germany.
Sebastian RothAnesthesiology Department, University Hospital Düsseldorf, Heinrich Heine University, Düsseldorf, Germany.
Alexandra StrodaAnesthesiology Department, University Hospital Düsseldorf, Heinrich Heine University, Düsseldorf, Germany.
Jan LarmannDepartment of Anesthesiology, Heidelberg University Hospital, Heidelberg, Germany.
Hans-Joerg GillmannDepartment of Anaesthesiology and Intensive Care Medicine, Hannover Medical School, Hannover, Germany.
Katarzyna KotfisDepartment of Anesthesiology, Intensive Care and Pain Management, Pomeranian Medical University, Szczecin, Poland.
Michael T GanterDepartment of Anesthesiology, Kantonsspital Winterthur, Winterthur, Switzerland.
Daniel BolligerClinic for Anaesthesia, Intermediate Care, Prehospital Emergency Medicine and Pain Therapy, University Hospital Basel, Basel, Switzerland.
Miodrag FilipovicDivision of Perioperative Intensive Care Medicine, Kantonsspital St Gallen, St Gallen, Switzerland.
Luca GuzzettiAnesthesia and Intensive Care Department, University Hospital, Varese, Italy.
Eckhard MauermannDepartment of Anesthesiology, Zurich City Hospital, Zurich, Switzerland.
Daniela IonescuDepartment of Anaesthesia and Intensive Care I, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
Savino SpadaroDepartment of Translational Medicine, University of Ferrara, Ferrara, Italy.
Wojciech SzczeklikCenter for Intensive Care and Perioperative Medicine, Jagiellonian University Medical College, Kraków, Poland.
Stefan De HertDepartment of Anaesthesiology and Peri-operative Medicine, Ghent University Hospital, Ghent University, Ghent, Belgium.
Beatrice Beck-SchimmerInstitute of Anaesthesiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Simon J HowellLeeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK.
Giovanna A Lurati BuseAnesthesiology Department, University Hospital Düsseldorf, Heinrich Heine University, Düsseldorf, Germany.
METREPAIR Investigators

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionHeart 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.

methodsThis 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.

resultsOf 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.

Indexed as

Heart FailurePostoperative ComplicationsSurgical Procedures, OperativeAgedChronic DiseaseCohort StudiesEchocardiographyFemaleHumansMaleMiddle AgedProspective StudiesRisk FactorsTreatment Outcomecardiovascular riskguideline adherencemortalitypostoperative complications

Identifiers

PMID40230320
PMCPMC12256159

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.