Chief Investigator: Dr. Giovanna LURATI BUSE (University Hospital Düsseldorf, Düsseldorf, Germany)


Dear MET-REPAIR Investigator, the Steering Committee is pleased to announce that patient recruitment for the MET-REPAIR main cohort (n=15771) and data cleaning is now completed. We congratulate all centres for this great achievement in terms of recruitment and for the excellent data quality thank to the joint efforts of all centres toward data cleaning in the last few months in spite of the pandemic.

The study statisticians will now review the data. We are looking forward to sharing with you the results in early 2021. Please remember to send to ESAIC research all pending end of study reports.

 Of notice: recruitment for the MET-REPAIR Frailty substudy (limited to UK centres)  is still ongoing until spring 2021.

Medical Problem

In Europe, inhospital mortality exceeded 7% in patients with coronary artery disease and in those with congestive heart failure.  Within 30 days of noncardiac surgery procedures, 8% of patients will suffer a major cardiovascular event. Considering this impressive burden, guidelines on cardiovascular assessment prior to non-cardiac surgery are regularly issued by the European Society of Anaesthesiology and of Cardiology. A core question in the preoperative cardiac risk assessment recommendations is the estimation of cardiovascular functional capacity in metabolic equivalents (METs) in spite of scarce and non-conclusive evidence on the prognostic value of functional capacity estimated by questionnaire for perioperative cardiovascular events. As such, anaesthesiologists all over Europe are currently forced to decide on the preoperative work-up and perioperative management of round 10 million European patients every year based on limited evidence.


The aim of the MET-REPAIR study is to address the question: “Are METs estimated by questionnaire associated with perioperative major adverse cardiovascular events and cardiovascular mortality in patients undergoing elevated-risk, noncardiac surgery?”

Outcome Measures

The primary endpoint will consist of in-hospital major adverse cardiovascular events including cardiovascular mortality, nonfatal cardiac arrest, acute myocardial infarction, stroke, congestive heart failure requiring transfer to a higher unit of care or prolonged stay on ICU. Secondary endpoints will include the single items of the primary composite endpoint, in-hospital all-cause mortality, complications ≥ 3 in Clavien Dindo Classification [28], and myocardial injury after noncardiac surgery (MINS) for centres implementing a perioperative troponin screening. Outcomes will be adjudicated by the local PI, unaware of functional capacity, based on in-hospital documentation and standardised definitions.


  • Study selected by ESAIC Research Committee: March 2016
  • Recruitment of patients: Start July 2017

Steering Committee

Giovanna Lurati Buse Germany, (Switzerland/Germany), Beatrice Beck-Schimmer (Switzerland), Stefan De Hert (Belgium), Miodrag Filipovic (Switzerland), Daniela Ionescu (Romania), Eckhard Mauermann (Switzerland), Wojciech  Szczeklik (Poland), Salome Dell-Kuster (Statistician, Switzerland


The Study is entirely sponsored by a grant from the European Society of Anaesthesiology and Intensive Care Clinical Trial Network (ESAIC CTN). The aim of the European Society of Anaesthesiology and Intensive Care Clinical Trial Network is to provide an infrastructure for clinical research in the fields of Anaesthesia, Pain, Intensive Care and Emergency Medicine by transnational European collaborative studies.

Contact us

European Society of Anaesthesiology and Intensive Care

Rue des Comédiens 24
1000 Brussels, Belgium
T: +32 2 743 32 94 / +32 2 210 94 14
F: +32 2 743 32 98