Osteoarthritis | Risk Factor Control Before Orthopedic Surgery

Osteoarthritis research study

What is the primary objective of this study?

This trial is designed to determine the best preoperative management strategy for patients undergoing orthopedic surgery.

Who is eligible to participate?

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

Which medical condition, disease, disorder, syndrome, illness, or injury is researched?


Cardiovascular Disease

Study Interventions

Interventions can include giving participants drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available or noninvasive approaches such as surveys, education, and interviews.

Drug:Metoprolol25mg PO BID if the HR is elevated at preadmission testing

Drug:Lisinopril2.5mg PO QD if the HR is elevated at preadmission testing

Drug:Atorvastatin80mg PO QD at preadmission testing

Behavioral:Lifestyle counselingDiet, exercise, medication adherance and smoking counseling

Study Arms

Research studies and clinical trials typically have two or more research arms. An arm is a group of people who receive the same treatment in the study.

TreatmentLifestyle counseling (nutrition, physical activity, medication compliance and smoking cessation) Atorvastatin 80mg PO QD Metoprolol 25mg PO BID if HR is elevated Lisinopril 2.5 mg PO QD if SBP is elevated

ControlStandard of care

Study Status


Start Date: February 2014

Completed Date: December 2018

Phase: Phase 4

Type: Interventional


Primary Outcome: Composite of cardiovascular events

Secondary Outcome: Modified composite of cardiovascular events

Study sponsors, principal investigator, and references

Principal Investigator: Jeffrey Berger, MD

Lead Sponsor: New York University School of Medicine


More information:

Discuss Lisinopril