Involving almost 30 cardiac centres across the UK, the randomised trial is designed to identify the safest and most effective blood-thinning treatment to use after heart valve surgery for patients who also have an irregular heartbeat.
Professor Julie Sanders, Professor of Cardiovascular Care in the Faculty of Nursing, Midwifery and Palliative Care, is nurse lead on the investigative team of a new national randomised controlled trial into heart surgery, led by The James Cook University Hospital in Middlesborough.
Each year, thousands of people in the UK have surgery for mitral regurgitation - a common heart condition where the mitral valve fails to close tightly, allowing blood to leak backward into the left atrium instead of pumping forward to the body. This forces the heart to work harder, which can lead to fatigue, shortness of breath, and potential heart failure.
If these patients also have an irregular heartbeat (atrial fibrillation) they usually need blood-thinning medication to reduce their risk of having a stroke or other complications after surgery.
While current national and international guidelines recommend using a vitamin K antagonist such as warfarin, a newer group of medicines known as Direct Oral Anticoagulants are also now widely used. This new randomised trial aims to show which option offers the best long-term outcomes for patients.
Professor Julie Sanders is also the Cardiothoracic Interdisciplinary Research Network (CIRN) lead for nurses and allied professionals on the trial. This role offers an opportunity for nurses and allied health professionals to gain principal investigator experience via the NIHR Associate PI Scheme. This is crucial to promote research capacity and capability in cardiac surgery. Having this infrastructure and CIRN support at the site-level aims to help drive patient recruitment and retention, enhancing the trial delivery.
Professor Sanders says, “It is an honour to be part of the investigative team ensuring the nursing perspective is included also while promoting and supporting other nurses and allied professionals in cardiac surgery around the UK to gain real insight and experience in research.”
Professor Enoch Akowuah, chief investigator for the The AFFECT trial at University Hospitals Tees said: “This is an important question for both patients and clinicians.
“We know anticoagulation is essential for patients with atrial fibrillation after mitral valve repair, but we do not yet know which treatment offers the best balance of safety and protection.
“The AFFECT Trial will provide high-quality evidence to guide national treatment decisions and improve long-term outcomes for patients across the UK and internationally."
