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Myocardial ischaemia after hip and knee arthroplasty: incidence and risk factors

Anne Ruth Bass1, Tomás Rodriguez2, Gina Hyun2

  • 1Division of Rheumatology, Department of Medicine, Hospital for Special Surgery, Weill Cornell Medical College, 535 E 70th Street, New York, NY, 10021, USA. BassA@hss.edu.

International Orthopaedics
|July 10, 2015
PubMed

Insights

Subclinical myocardial ischaemia (MI) is common after hip and knee replacement surgery. Elderly patients and those with diabetes face the highest risk of developing MI post-arthroplasty.

Area of Science:

  • Orthopedic Surgery
  • Cardiology
  • Geriatric Medicine

Background:

  • Postoperative myocardial ischaemia (MI) is a significant predictor of long-term cardiac morbidity and mortality.
  • Understanding MI prevalence and risk factors in arthroplasty patients is crucial for improving patient outcomes.

Purpose of the Study:

  • To determine the prevalence of myocardial ischaemia (MI) in patients undergoing hip or knee arthroplasty.
  • To identify risk factors associated with MI in this patient population.

Main Methods:

  • A cohort of 394 patients aged 65 years or older undergoing hip or knee arthroplasty were studied.
  • High-sensitivity cardiac troponin T (hs-cTnT) levels were measured on postoperative day two.
  • The Genetics-InFormatics Trial (GIFT) provided the patient samples and data.

Main Results:

  • The prevalence of MI was 13.5% (53 participants), with only three clinically diagnosed cases.
  • Increasing age (OR 3.52 per decade) and diabetes (OR 2.23) were significant risk factors for MI.
  • While associated with MI, hypertension, coronary artery disease, and tobacco use did not reach statistical significance.

Conclusions:

  • Subclinical myocardial ischaemia is frequent following arthroplasty procedures.
  • Elderly patients and those with diabetes are identified as high-risk groups for postoperative MI.
  • These findings highlight the need for cardiac monitoring in at-risk arthroplasty patients.
Abstract

Keywords:
ArthroplastyMyocardial ischaemiaPostoperative complicationRisk factorStatinTroponin

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