Research Priorities in Critical Care Cardiology: JACC Expert Panel
P Elliott Miller1, Kurt Huber2, Erin A Bohula3
1Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, Connecticut, USA.
Insights
Critical care cardiology (CCC) research faces slow evidence generation for complex cardiac intensive care unit (CICU) patients. Addressing research barriers is crucial for improving CCC clinical practice and patient outcomes.
Area of Science:
- Cardiology
- Intensive Care Medicine
- Clinical Research
Background:
- The cardiac intensive care unit (CICU) population has evolved significantly, presenting complex cases.
- High-quality evidence generation for critically ill cardiac patients has lagged behind clinical needs.
- Existing clinical trials often exclude or underrepresent the specific patient demographics found in CICUs.
Purpose of the Study:
- To identify priority areas for critical care cardiology (CCC) research.
- To outline current challenges in conducting research within the CICU setting.
- To propose essential elements for advancing CCC research.
Main Methods:
- This study presents a multinational perspective.
- It synthesizes current challenges and proposes future research directions.
- The focus is on identifying barriers and solutions for CCC research.
Main Results:
- There is a scarcity of clinical trials specifically designed for the CICU patient population.
- Lack of high-quality evidence leads to practice variations in common CICU diagnoses.
- Barriers to research exist, common to critical care and unique to CCC.
Conclusions:
- Urgent need for focused research in critical care cardiology to address evidence gaps.
- Overcoming research barriers is essential for advancing CCC.
- A strategic path forward is required to improve the management of critically ill cardiac patients.
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, the 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 that either exclude or poorly represent 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.
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