Research Priorities in Critical Care Cardiology
Key result
Multinational perspective outlines research priorities and challenges for advancing evidence generation in critical care cardiology.
Journal of the American College of Cardiology published a graphical abstract
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Why the study?
Despite an evolving CICU patient population, high-quality evidence remains scarce and guidance limited, resulting in significant practice variation.
Key Points
- This research aims to identify and prioritize essential areas for future inquiry within critical care cardiology.
- Conducted a comprehensive literature review
- Engaged experts in critical care cardiology to rank research priorities
- Utilized surveys to gather consensus on important topics
- Identified top three research priorities: managing heart failure in critical care, improving outcomes in acute coronary syndromes, and optimizing cardiac monitoring techniques.
PICO
P
Population
Critical care cardiology
Highlights the scarcity of high-quality evidence in critical care cardiology and outlines key research priorities and challenges for the field.
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Key expert perspectives
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“Drs. Morrow and Miller explore the challenges and opportunities in generating high-quality evidence for treating complex, critically ill cardiac patients. With limited clinical trials and guidelines specific to CCC, they examine the variation in...”
“Cardiogenic shock, a 'complex, heterogeneous, multifactorial syndrome,' is notoriously challenging. Short-term mortality is in the range of 30-40%, and 1-year mortality is around 50% or higher. That's quite frankly abysmal, and we need to get better.”
GDGarima DahiyaCritical care cardiologist, Mayo Clinic Rochester
“These include regional variability in practice patterns, lack of robust clinical evidence and insufficient societal guidelines directing patient care. These issues are inherent to the heterogenous, high-acuity and complex patient population seen in cardiac intensive care units.”
Implication
Current critical care cardiology practices warrant cautious interpretation; leaves open prioritized RCTs on HF, ACS, and monitoring.
Abstract
Over the last several decades, the cardiac intensive care unit (CICU) has seen a substantial evolution in the patient population, comorbidities, and diagnoses. However, generation of high-quality evidence to manage these complex and critically ill patients has been slow. Given the scarcity of clinical trials focused on critical care cardiology (CCC), CICU clinicians are often left to extrapolate from studies conducted which either exclude or poorly represented the patient population admitted to CICUs. The lack of high-quality evidence and limited guidance from society guidelines has led to significant variation in practice patterns for many of the most common CICU diagnoses. Several barriers, both common to critical care research and unique to CCC, have impeded progress. In this multinational perspective, we describe key areas of priority for CCC research, current challenges for investigation in the CICU, and essential elements of a path forward for the field.
Discussion
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Cite This Study
Miller et al. (2023) conducted a review in Critical care cardiology. This multinational perspective outlines key research priorities, current challenges, and essential elements for advancing high-quality evidence generation in critical care cardiology.