Heart Damage After Vascular Surgery Raises Death Risks
Screening is urged because many people have no symptoms, researchers say
FRIDAY, June 12, 2009 (HealthDay News) -- People who suffer heart damage after vascular surgery face a higher risk of dying within the next few years, even if they show no symptoms of heart problems, a new study has found.
Lack of symptoms is common, according to the researchers.
In the study, which involved 1,545 people who had elective vascular surgery, 284 were found to have heart damage after surgery. However, 75 percent of them were either asymptomatic or their symptoms were masked by postoperative pain or nausea, the study found.
The study was to be presented June 12 in Denver at the annual meeting of the Society for Vascular Surgery.
The researchers tested the cardiac troponin T (cTnT) levels of the study participants one, three and seven days after their surgery and when they were discharged. Elevated levels of cTnT, a protein key to cardiac muscle contraction, indicate heart damage.
After surgery, heart damage was found to have occurred in 213 people who showed no symptoms and 71 who had symptoms, according to the researchers.
"Patients undergoing major arterial vascular surgery because of atherosclerotic disease are at high-risk for cardiac complications in the perioperative period," Dr. Olaf Schouten of the Erasmus Medical Center of Rotterdam, the Netherlands, said in a news release from the society.
"It is estimated that one out of five patients undergoing major vascular surgery suffers cardiac damage around the time of the operation if patients are appropriately screened in the first week after surgery," Schouten added. "Screening is a valuable tool to determine how aggressive medical therapy should be for their long-term prognosis."
During 3.7 years of follow-up, 40 percent of those with asymptomatic cardiac damage died, compared with 13 percent of people without cardiac damage. After adjusting for the type of surgery and known risk factors such as diabetes, heart failure and heart attacks, people with cardiac damage had more than twice the risk of dying in the years shortly after surgery, the study reported..
"Asymptomatic cTnT release, without clinical symptoms or new ECG changes, is associated with an increased long-term mortality in patients undergoing vascular surgery," Schouten concluded.
The Society for Vascular Surgery has more on vascular conditions and treatments.