Findings suggest longer delay between elective surgery and heart attack

Soon-to-be-published research suggests that patients who recently had a heart attack wait longer than current recommendations before undergoing elective operations.

Christian de Virgilio

Current recommendations by the American Heart Association and the American College of Cardiology advise that patients wait at least 4 to 6 weeks after a heart attack before undergoing elective surgery, according to a press release.

“Despite medical advancements in the treatment of coronary artery disease today, a recent heart attack remains an important risk factor for patients undergoing surgery,” Christian de Virgilio, MD, a corresponding author for the study scheduled to be published in the May issue of Annals of Surgery, stated in the release. “Our study suggests that patients should wait at least 8 weeks after a heart attack before undergoing elective surgery. The results of the study also reignite the question of whether, in this high-risk group, physicians should consider coronary artery stenting or bypass prior to elective surgery.”

De Virgilio and colleagues studied the outcomes of more than 550,000 patients in California who underwent either elective hip surgery, non-traumatic amputation, gallbladder removal, colon resection, or abdominal aortic anurysm repair between 1999 and 2004 after a heart attack. They discovered substantially lower mortality rates and fewer subsequent heart attacks among patients who waited at least 8 weeks after a heart attack to undergo the studied elective procedures, according to the release.

The investigators also found that the risk of mortality and subsequent heart attack generally decreased with a longer delay between the heart attack and elective surgery. Among patients who underwent hip surgery within 30 days of a heart attack, the study showed a 30-day mortality rate of 13.1% and 38.4% risk of a subsequent heart attack. Those who had surgery 6 months to 1 year after a heart attack had a 7.9% 30-day mortality rate and 6.2% risk of subsequent heart attack.

“Our research examined a much wider range of patients and surgeries than in past studies, and it points out the importance of a recent heart attack in determining the timing for elective surgeries,” de Virgilio, a principal investigator at Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, stated in the release.

Reference:
www.labiomed.org
Disclosure: Dr. de Virgilio has no relevant financial disclosures.

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