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

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 inhospital 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, inhospital 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 inhospital documentation and standardised definitions.


  • Study selected by ESA Research Committee: March 2016
  • Call for centres: Ongoing
  • Recruitment of patients: Start July 2017

Join the study

This study will recruit as many participating institutions as possible across the 30 European countries represented at the ESA Council. It is plan to recruit at least 15,000 patients.

Would your hospital like to join this study as an actively contributing research centre?
The ‘Call for Centres form’ must be filled in online. The completion of this form will facilitate the coordination and is mandatory for participation in ESA CTN. ESA Secretariat will then contact you providing you with additional information. Please visit the call for centres page.

 List of MET-REPAIR registered centres.

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

National Coordinating Investigators

The ESA Secretariat and Steering Committee have identified already some National Coordinating Investigator to support the conduction of MET-REPAIR and to answer first line and local/national questions. Please find the study key contacts list HERE.


The Study is entirely sponsored by a grant from the European Society of Anaesthesiology Clinical Trial Network (ESA CTN). The aim of the European Society of Anaesthesiology 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

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