Increased heart attack risk associated with total hip, knee replacement surgeries
Total hip replacement (THR) and total knee replacement (TKR) surgeries were associated with increased risk of acute myocardial infarction (AMI, heart attack) in the first two weeks after the surgical procedures, according to report published Online First by Archives of Internal Medicine, a JAMA Network publication.
THR and TKR are effective for treating patients with moderate to severe osteoarthritis. These surgical procedures are commonly performed, with an estimated 1.8 million procedures performed annually worldwide, according to the study background.
"This study demonstrated an increased risk of AMI during the first two weeks after THR (25-fold) and TKR (31-fold) surgery compared with matched controls. The risk of AMI sharply decreased after this period, although it remained significantly elevated in the first six weeks for THR patients. The association was strongest in patients 80 years or older, whereas we could not detect a significantly increased risk in patients younger than 60 years," Arief Lalmohamed, Pharm.D., of Utrecht University, the Netherlands, and colleagues comment.
Researchers utilized Danish national registries for their study that enrolled patients who underwent THR or TKR (n=95,227) from January 1998 through December 2007 and 286,165 individuals as matched controls. The mean (average) age for THR patients was just less than 72 years and for TKR patients it was just more than 67 years.
The absolute six-week risk of AMI was 0.51 percent in THR patients and 0.21 percent in TKR patients, according to the results.
"Furthermore, a previous AMI in the six months before surgery increased the risk of new AMI during the first six weeks after THR and TKR (4-fold increase) surgery but did not modify the relationship between THR or TKR and AMI," the authors conclude.
In a commentary, Arthur W. Wallace, M.D., Ph.D., of the University of California, San Francisco, writes: "The perioperative period is stressful to patients The present study once again confirms that the perioperative period increases cardiac risk. Physicians must go further than establishing risk factors; physicians must actively work to reduce perioperative risk."
"It is important for physicians caring for patients in the perioperative period to recognize the potential for cardiac morbidity and mortality and then appropriately use the armamentarium of medical therapies we now have to reduce cardiac risk, prevent perioperative MIs (myocardial infarction, heart attack), and prevent cardiac deaths," Wallace continues.
"In their present study, Lalmohamed et al clearly reinforce the importance and significance of the cardiac risk and the need to prevent perioperative cardiac morbidity and mortality," Wallace concludes.
Journal reference: JAMA Internal Medicine
Provided by JAMA and Archives Journals
- Knee replacement may lower a patient's risk for mortality and heart failure Feb 07, 2012 | not rated yet | 0
- 4.5 million Americans living with total knee replacement Feb 10, 2012 | not rated yet | 0
- Study evaluates blood potassium levels after heart attack and risk of in-hospital mortality Jan 10, 2012 | not rated yet | 0
- Study examines link between beta-blocker use and risks of death and heart attack after surgery Oct 20, 2008 | not rated yet | 0
- Post surgical phone support improves outcome following knee replacement Feb 07, 2012 | not rated yet | 0
- Motion perception revisited: High Phi effect challenges established motion perception assumptions Apr 23, 2013 | 3 / 5 (2) | 2
- Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update) Apr 02, 2013 | 4.5 / 5 (11) | 5
- The visual system as economist: Neural resource allocation in visual adaptation Mar 30, 2013 | 5 / 5 (2) | 9
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
The idea behind a reverse shock
5 hours ago So in a supernova explosion for example (5th slide) http://www.astro.princeton.edu/~burrows/classes/541/blastwavesChisari.pdf Ambient medium is...
Guass's Law for a charge distribution
6 hours ago First, this is not a homework question, just something I've been confused about for some time. I understand how to use Guass's law in many ways but...
6 hours ago Hello :) i'm new to this forum, so excuse me for my straightforwardness ;) I'm working on my bachelor work and i can't find a solution. I'm writing...
siphon and bernouli theorum
8 hours ago 1. I found this diagram on book but there weren't any description.can someone tell me, what its trying to tell specially by those two red lines...
Hot gas expansion rate into outer space
8 hours ago Good Morning Sirs, it seems to be surprisingly hard to get the numbers of a mystery: How fast expand hot rocket exhaust gases into empty space? ...
Magnetic field lines through copper
13 hours ago Hello. Assume an electron gun, as in CRT, made of plumbing copper instead of glass. Using magnetic scanning coils to move electron beam. Will the...
- More from Physics Forums - Classical Physics
More news stories
Heart failure accelerates the aging process and brings on early andropausal syndrome (AS), according to research presented today at the Heart Failure Congress 2013. AS, also referred to as male 'menopause', was four times ...
Cardiology 11 hours ago | not rated yet | 1
Mortality and length of stay are highest in heart failure patients admitted in January, on Friday, and overnight, according to research presented today at the Heart Failure Congress 2013. The analysis of nearly 1 million ...
Cardiology 11 hours ago | not rated yet | 0
Coenzyme Q10 decreases all cause mortality by half, according to the results of a multicentre randomised double blind trial presented today at Heart Failure 2013 congress. It is the first drug to improve heart failure mortality ...
Cardiology 12 hours ago | 5 / 5 (2) | 5
Transcatheter aortic valve implantation (TAVI) is effective and safe in Asian patients, according to early experience based on first results from a multicentre Asian registry reported at EuroPCR 2013.
Cardiology May 24, 2013 | not rated yet | 0
Routinely measuring fractional flow reserve (FFR) using pressure wire assessment during coronary angiography for diagnosis of chest pain leads to significant changes in the management of one in four patients, according to ...
Cardiology May 24, 2013 | not rated yet | 0
(HealthDay)—Animals make great companions for senior citizens, but elderly people who always drive with a pet in the car are far more likely to crash than those who never drive with a pet, researchers have ...
3 hours ago | not rated yet | 0
(AP)—Department of Justice lawyers have again asked a federal appeals court in New York to delay lifting age restrictions and prescription requirements on an emergency contraceptive popularly known as the morning-after ...
11 hours ago | not rated yet | 0
(Medical Xpress)—A research team, led by Jeremy Barr, a biology post-doctoral fellow, unveils a new immune system that protects humans and animals from infection.
May 20, 2013 | 4.8 / 5 (30) | 9 |
Until now, little was scientifically known about the human potential to cultivate compassion—the emotional state of caring for people who are suffering in a way that motivates altruistic behavior.
May 22, 2013 | 5 / 5 (4) | 6 |
Women at a particular stage in their monthly menstrual cycle may be more vulnerable to some of the psychological side-effects associated with stressful experiences, according to a study from UCL.
May 24, 2013 | 4 / 5 (4) | 4 |
Salamanders' immune systems are key to their remarkable ability to regrow limbs, and could also underpin their ability to regenerate spinal cords, brain tissue and even parts of their hearts, scientists have ...
May 20, 2013 | 4.9 / 5 (7) | 5 |