Cardiac surgery has been a highly innovative field of medicine. The introduction of major innovations, and ongoing incremental change in existing ones, have extended survival and improved quality of life for many patients suffering from cardiac disease. A rapid pace of innovation requires a rigorous infrastructure for clinical evaluation that provides timely assessments of the value of new and modified treatments. The Cardiothoracic Surgical Trials Network (CTSN) was created to provide a rigorous evidence base tor the surgical treatment of cardiothoracic disease. The International Center for Health Outcomes and Innovation Research (InCHOIR) enthusiastically embraces the opportunity to continue to work in partnership with clinical investigators and the NIH as the CTSN DCC. The Network has developed a rich research agenda for the renewal that includes trials of novel neuroprotective agents, long-term antithrombotic strategies, new regenerative medicine therapies, and surgical approaches to valvular disease, heart failure and atrial fibrillation. Given our long-standing interest and experience in the design and analysis of cardiac surgery multicenter studies, we are in a strong position to serve as the coordinating center for this vital clinical research effort. In particular, we will provide leadership in designing novel trials that optimize sample size, include patient- centered as well as clinical endpoints, and collect data from a variety of sources, including electronic data capture systems, mobile apps and wearable sensors, registries and electronic health records. We have a strong track record of obtaining efficient regulatory approval for our trials from the FDA and Health Canada, training and monitoring sites nationally and internationally, ensuring robust enrollment and retention, data management and quality assurance, data sharing, and overall administrative coordination. We have the infrastructure to expand our trials to include mechanistic studies that use biospecimens collected and managed through the CTSN biorepository. Finally, the DCC plays an important role in the analysis, interpretation and dissemination of research findings. We will continue to support the process of publishing in high-impact journals that should lead to revision of practice guidelines and to surgical practice itself. This goal should be further optimized by incorporating Implementation Science approaches into Network trials, which should decrease the well-recognized gap between publication of trial results and adoption of findings into widespread practice.

Public Health Relevance

Clinical trials are a critical step in translating discoveries into better treatments for people burdened by cardiac disorders. Such trials typically require cooperation and coordination among a broad range of investigators, patients, government agencies, and industry partners. The objective of the Cardiothoracic Surgical Trials Network (CTSN) is to increase the effectiveness and efficiency of clinical research through shared infrastructure for important trials that will advance therapy for patients suffering from cardiac disease.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project--Cooperative Agreements (U01)
Project #
2U01HL088942-12
Application #
9753639
Study Section
Special Emphasis Panel (ZHL1)
Program Officer
Miller, Marissa A
Project Start
2007-07-01
Project End
2026-02-28
Budget Start
2019-04-12
Budget End
2020-02-29
Support Year
12
Fiscal Year
2019
Total Cost
Indirect Cost
Name
Icahn School of Medicine at Mount Sinai
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
078861598
City
New York
State
NY
Country
United States
Zip Code
10029
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