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Joint Replacement Linked to Cardiac Complications

Revision surgery, bilateral joint replacement increases odds of cardiac complications

THURSDAY, July 31 (HealthDay News) -- Among total joint replacement surgery patients, two new risk factors -- revision surgery and bilateral joint replacement -- as well as traditional risk factors increase odds of cardiac complications, according to an article published in the July issue of Arthritis & Rheumatism.

Frederick C. Basilico, M.D., of New England Baptist Hospital in Boston, and colleagues performed a case-control study of patients who underwent a primary or revision total knee or total hip replacement surgery to ascertain risk factors for cardiac complications following total joint replacement surgery. Cases consisted of patients receiving a total joint replacement and experiencing a cardiac complication, while controls, matched to cases for age, year and surgeon, received a total joint replacement and did not experience any cardiac complication.

The sample included 209 cases and 209 matched controls. In adjusted analyses, history of coronary artery disease, myocardial infarction, congestive heart failure or valvular heart disease increased the odds of cardiac complications by 1.6 times, the researchers report. Arrhythmia, revision surgery or bilateral surgery increased the odds of cardiac complications 2.6, 2.2 and 3.5 times, respectively, they note.

"The results of this study confirm that several traditional risk factors for cardiac complications of non-cardiac surgery also apply to the population of patients undergoing total joint arthroplasty," the authors conclude. Additionally, "this study identified a new high-risk group, namely, patients undergoing revision or bilateral total joint replacement surgery."

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