Population Health
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Population Health. Research Institute. Steroids In caRdiac Surgery (SIRS) Trial. Population Health Research Institute Hamilton Health Sciences/McMaster University Hamilton, Canada. SIRS was funded by grants from the Canadian Institutes of Health Research (CIHR)

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Population Health

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Population health

Population Health

Research Institute

Steroids In caRdiac Surgery (SIRS) Trial

Population Health Research Institute

Hamilton Health Sciences/McMaster University

Hamilton, Canada

SIRS was funded by grants from the Canadian Institutes of Health Research (CIHR)

and the Canadian Network and Centre for Trials Internationally(CANNeCTIN)


Population health

Trial Flow Diagram

Randomized (n = 7,507)

Allocated to steroid* (n = 3,755)

Allocated to Placebo (n = 3,752)

Lost to follow-up (n = 1)

Did not receive study drug (n = 105)

Lost to follow-up (n = 0)

Did not receive study drug (n = 106)

Analyzed by intention-to-treat (n = 3,752)

Complete follow-up data (n = 3,751)

Analyzed by intention-to-treat (n = 3,755)

Complete follow-up data (n = 3,754)

*500 mg IV Methylprednisolone given intra-operatively


Population health

Co-Primary Outcomes (30 days)


Population health

Conclusion

Methylprednisolone does not reduce death or major morbidity at 30 days for high-risk patients undergoing cardiac surgery with the use of cardiopulmonary bypass.

Methylprednisolone increases the risk of early post-operative myocardial infarction, defined by CK-MB biomarker release.


Population health

Implications

Methylprednisolone should not be administered prophylactically to high-risk patients undergoing cardiac surgery with the use of cardiopulmonary bypass.

Further work is necessary to understand the mechanism of steroid-driven myocardial infarction.


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