RESEARCH - New risk factors for cardiovascular problems after joint surgery identified

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New Risk Factors for Cardiovascular Problems After Joint Surgery Identified

NEW YORK (Reuters Health) Aug 18 - In addition to confirming

previously identified risk factors for cardiovascular complications

after total joint replacement (TJR) surgery, researchers have shown

that bilateral and revision operations are associated with increased

risk.

" Revision joint replacement and bilateral surgery are much more

prolonged operations than primary unilateral joint replacement, " Dr.

N. Katz, from Brigham and Women's Hospital in Boston, said in

a statement. " These findings suggest an increased risk with more

prolonged surgery. "

The results, reported in the July issue of Arthritis and Rheumatism,

come from a case-control study of 209 patients who experienced an MI,

heart failure, unstable angina, arrhythmia, symptomatic hypotension,

or pulmonary embolism during the surgical admission for TJR, and 209

matched patients who did not have cardiovascular complications.

In line with prior findings, older age at surgery (odds ratio, 1.7),

history of arrhythmia (OR, 2.6), and history of coronary artery

disease, MI, heart failure, or valvular heart disease (OR, 1.6) all

increased the risk of cardiovascular complications.

The strongest risk factor, however, was one of the newly identified

ones, bilateral surgery, which increased the risk by 3.5-fold.

Revision surgery also greatly increased the risk (OR, 2.2).

" Clinicians can use this information to better estimate the risk of

cardiovascular complications following TJR surgery, " Dr. Katz said,

" and, ultimately, to prevent and better manage these complications. "

Arthritis Rheum 2008;58:1915-1920.

http://www.medscape.com/viewarticle/579198

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Not an MD