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Incidence of Heart Failure Following Carpal Tunnel Release Surgery

Harrison S Fellheimer1, Mahaa Ayub1, Gabriel I Onor2

  • 1Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA.

Journal of Hand Surgery Global Online
|July 29, 2025
PubMed

Insights

Carpal tunnel release surgery increases heart failure risk. Patients undergoing carpal tunnel surgery had a higher incidence of heart failure (HF) compared to those who did not have surgery.

Area of Science:

  • Cardiology
  • Neurology
  • Surgical Outcomes

Background:

  • Previous studies suggest a link between carpal tunnel syndrome (CTS) and heart failure (HF).
  • Amyloid deposition in CTS may precede amyloid cardiomyopathy.
  • A potential prodromal relationship between CTS and HF warrants investigation.

Purpose of the Study:

  • To investigate the hypothesis that patients undergoing carpal tunnel release surgery have an increased risk of developing heart failure.
  • To compare the incidence of HF in patients who underwent carpal tunnel surgery versus those who did not.

Main Methods:

  • Utilized the TriNetX database to identify patients with carpal tunnel syndrome (CTS).
  • Included patients who underwent surgical treatment (endoscopic or open carpal tunnel release).
  • Propensity score matching adjusted for demographics and comorbidities; primary outcome was heart failure (HF).

Main Results:

  • The incidence of HF in patients after carpal tunnel release was 3.49% at 5 years, increasing to 7.102% at 20 years.
  • Surgical patients showed a statistically significant increased risk ratio (RR) for HF (1.129) at five years post-surgery (P < .0001).
  • The risk difference for HF peaked at 2.007% at 20 years, with an RR of 1.369 compared to nonsurgical controls.

Conclusions:

  • Patients undergoing carpal tunnel release surgery have a significantly higher likelihood of developing heart failure compared to matched nonsurgical controls.
  • The study highlights an increased association between CTS and HF, exceeding general population rates.
  • Hand surgeons play a vital role in early identification of HF risk in CTS patients, prompting cardiovascular assessment.
Abstract

Keywords:
Carpal tunnel syndromeDatabase studyHeart failure

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