New research suggests that the incidence of myocardial ischemia (MI) after a major orthopedic surgery among patients with cardiac risk factors is more likely.
The study, published in HSS Journal, showed that patients with higher postoperative cTnI levels were more likely to experience cardiac complications following hip or knee replacement surgery and spinal fusions.
"Cardiovascular events are the most serious complications after major orthopedic surgeries, and patients with myocardial ischemia are at significant risk," said lead author Michael K. Urban, MD, PhD, a physician at the Hospital for Special Surgery (HSS) in New York, in a statement. "We recommend measuring levels of a cardiac protein, troponin, which is released into the blood during cardiac injury. Identifying patients with elevated troponin levels, allows us to intervene to prevent further cardiac events to improve outcome and reduce the overall cost of care."
The data also showed spinal fusions were the most dangerous for heart patients, putting them at nearly four times the risk of cardiac events compared with joint replacement procedures.
In one year, more than 10,600 inpatient orthopedic procedures were performed at HSS and more than 800 patients were identified as at risk for postoperative myocardial ischemia. About 90 percent of myocardial ischemic events happened by the third day after surgery.
"As demand for orthopedic surgery continues to rise, it is imperative that we identify more effective and efficient ways to reduce post-surgical complications," Urban said. "We believe measuring troponin levels in high-risk patients after orthopedic surgery can advance the management of patients with heart disease and reduce complications."