OPTMIZE-OSOptimization of Pre-surgical Testing With an Intensive Multifactorial Intervention to MinimiZe Cardiovascular Events in Orthopedic Surgery

Fecha de inicio: 1 de febrero de 2014

Inclusion Criteria: • ≥ 21 years of age Subjects undergoing open orthopedic surgery of the hip, knee or spine Surgery is scheduled at least 3 days after PAT visit and no more than 14 days. High risk subject cohort Coronary artery disease, or Cerebrovascular disease (prior stroke, TIA or carotid artery disease (>70% stenosis), or Peripheral artery disease, or Prior Venous thromboembolism or arterial thromboembolism, or Age ≥ 60 years and 2 of the following Renal insufficiency (creatinine clearance < 60ml/min) Diabetes COPD Hypertension Active smoker or stopped less than 30 days prior to consent Cancer (excluding BCC) Heart Failure Exclusion Criteria: • Known intolerance to statins Subject is already on maximum dose statin (atorvastatin/Lipitor 80mg daily or rosuvastatin/crestor 40mg daily) Bilateral renal artery stenosis End stage renal disease (receiving dialysis or CrCl <30ml/min) Known allergy or intolerance to ACE-inhibitor (other than cough) or Angiotensin receptor blocker (e.g. angioedema, hyperkalemia) Known allergy or intolerance to beta blockers Known sick sinus syndrome not treated with permanent pacemaker Known greater than first degree AV block not treated with a pacemaker Excessive alcohol intake Acute Coronary Syndrome requiring hospitalization within 1 month Stroke within 1 month Known pregnancy Severe co-morbid condition with life expectancy < 6 months Inability to give informed consent or adhere to follow-up as per protocol Current participation in another investigational drug or device trial