title: The unmet need for addressing cardiac issues in intensive care research.
abstract: OBJECTIVE
  Patients with primary cardiovascular disorders and comorbidities are commonly admitted to ICUs; however, little is known about the current state of cardiac research being conducted in these adult ICU patients.
  
  
  METHODS
  Retrospective analysis.
  
  
  METHODS
  None.
  
  
  METHODS
  In separate searches of ongoing phase II-IV clinical trials registered with ClinicalTrials.gov and funding grants available in the Canadian Institutes for Health Research funding decision database between 1999 and 2012, we identified all research initiatives focused on adult ICU patients.
  
  
  METHODS
  None.
  
  
  RESULTS
  The primary outcome of interest was the proportion of cardiac-specific ICU studies, defined as any involving a cardiac population with a cardiac intervention (or observation for observational analyses) and/or a cardiac outcome. A total of 192 unique studies including adult ICU patients were identified from the ClinicalTrials.gov database. These were most commonly classified as respiratory or ventilation (19%), infectious (14.1%), or neurologic (12.0%) in focus. A total of 105 grants were identified in the Canadian Institutes for Health Research database. Funded studies most commonly addressed respiratory or ventilator questions (18.1%), infectious disease issues (12.4%), or hematological/thrombosis questions (9.5%). Only 4.6% of all ICU studies in ClinicalTrials.gov and 1.9% of all Canadian Institutes for Health Research grants could be considered cardiac.
  
  
  CONCLUSIONS
  These findings highlight the relative paucity of cardiac-specific research in the intensive care setting relative to the high prevalence of acute cardiac diseases and comorbidities. This observed disparity warrants timely attention and should lead to meaningful research opportunities aimed at improving the outcomes of critically ill cardiac patients.
authors.affiliation: 1Divisions of Critical Care and Cardiology, University of Alberta, Edmonton, Alberta, Canada. 2Duke Clinical Research Institute, Duke University Medical Center, Durham, NC. 3Division of Critical Care, University of Alberta, Edmonton, Alberta, Canada. 4Milton S. Hershey Medical Center, Penn State University, Hershey, PA. 5Cardiovascular Division, Brigham and Women's Hospital and Harvard Medical School, Boston, MA. 6Divisions of Cardiology and Pulmonary and Critical Care Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC.
authors.forename: Sean
authors.initials: S
authors.lastname: van Diepen
authors.forename: Christopher B
authors.initials: CB
authors.lastname: Granger
authors.forename: Michael
authors.initials: M
authors.lastname: Jacka
authors.forename: Ian C
authors.initials: IC
authors.lastname: Gilchrist
authors.forename: David A
authors.initials: DA
authors.lastname: Morrow
authors.forename: Jason N
authors.initials: JN
authors.lastname: Katz
mesh_terms: D000328:Adult; D035843:Biomedical Research / Q000706:statistics & numerical data*; D002170:Canada; D002318:Cardiovascular Diseases / Q000628:therapy*; D002986:Clinical Trials as Topic / Q000706:statistics & numerical data; D003422:Critical Care / Q000379:methods*; D006301:Health Services Needs and Demand; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D012106:Research; D012189:Retrospective Studies; D014481:United States