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Table 4 Checklist of construct validity for preclinical perioperative myocardial infarction (PeriopMI)

From: Assessment of safety and efficacy of mesenchymal stromal cell therapy in preclinical models of acute myocardial infarction: a systematic review protocol

Construct validity domain

Criteria from guidelinesa,b

Specific application to PeriopMI

Justification

Yes/No

Animal Subjects

Matching model to age of patients in clinical setting

Middle aged to elderly animal model used

Incidence of PeriopMI increases over age 50; age >75 is an independent risk factor for PeriopMI [46]

 

Matching model to co-morbidities in clinical setting

Animal model has ≥ 1 co-morbidity risk factor for PeriopMI, either chronic or acute (e.g. atherosclerosis, diabetes, chronic kidney disease, hypotension, acute blood loss)

Co-morbidities listed are independent risk factors for PeriopMI [47]

 

Outcome Measures

Matching of outcome measure to clinical setting

Late outcome measures performed (e.g. >3 weeks when scar formation and acute changes are complete)

A longer follow-up duration may reflect chronic effects of an acute therapy for PeriopMI

 

Modeling of Disease

Matching model to human manifestation of disease

Model reflects elements of Type 1 MI (e.g. plaque rupture) and/or Type 2 (e.g. supply demand imbalance)

Clinical PeriopMI displays aspects of Type 1 and Type 2 MI [30, 42]

 

A pro-inflammatory state is reported

Clinical PeriopMI has a large inflammatory burden [19]

 

Administration of Intervention

Treatment response along mechanistic pathway

Therapy given as a pretreatment (i.e. preventative) or within the first 48 h after anesthesia

Majority of PeriopMI occurs within the first 48 h after surgery

 

Environment

Address confounds associated with setting, experimental setting

Post-operative analgesia provided

Inadeqaute post-operative analgesia increases systemic inflammation

 
  1. Abbreviations: MI myocardial infarction, PeriopMI perioperative myocardial infarction
  2. aRecommendations to reduce threats to construct validity were identified by Henderson et al. [19]
  3. bConstruct validity criteria suggested by ≥40% of included guidelines included in checklist