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Increased early risk of myocardial infarction found after TJA
Although investigators of this study discovered an increased risk of myocardial infarction in the immediate postoperative period among patients who underwent total joint arthroplasty for osteoarthritis, this risk declined with longer follow-up. However, investigators found a higher risk of venous thromboembolism continued among arthroplasty patients throughout the median 4.2-year follow-up.
“Our findings provide the first general population-based evidence that osteoarthritis patients who have total knee or total hip replacement surgery are at increased risk of heart attack in the immediate postoperative period,” lead study author Yuqing Zhang, DSc, stated in a press release. “The long-term risk of heart attack was insignificant, but risk of blood clots in the lung remained for years after surgery to replace a hip or knee damaged by osteoarthritis.”
Researchers identified 13,849 patients who underwent total knee arthroplasty (TKA) and 6,063 patients who underwent total hip arthroplasty (THA) for osteoarthritis and were aged 50 years and older. All patients were matched to non-TKA and non-THA controls.
Results showed 306 cases of myocardial infarction in patients who underwent TKA vs. 286 in non-TKA controls. Investigators also found 128 cases of myocardial infarction in patients who underwent THA vs. 138 cases in non-THA controls.
Researchers found a higher cumulative incidence of myocardial infarction among patients who underwent TKA during the first 12 months before declining to a lower level than patients who did not undergo surgery during the rest of the follow-up period. Similarly, patients who underwent THA had a higher cumulative incidence of myocardial infarction during the first 6 months before declining to a lower level than patients who did not undergo surgery, according to study results. Researchers noted when looking at sex, age group, osteoarthritis duration, the Townsend Deprivation Index Score and history of cardiovascular disease, the relation of TKA or THA to the risk of myocardial infarction did not vary. – by Casey Tingle
Disclosure: The researchers report no relevant financial disclosures.