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Knee and Hip Replacements Linked to Heart Attacks

Older Age, Recent Heart Attacks Increased the Risks Associated With Joint Replacement Surgeries
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Previous studies have shown that joint replacements increase a patient's risk for dangerous blood clots that can lodge in the legs or lungs. For that reason, joint replacement patients are routinely prescribed blood thinners to prevent those kinds of events.

Researcher Arief Lalmohamed, PharmD, a pharmacist at the University of Utrecht, says the risks of heart attacks after surgery haven't been fully appreciated.

He isn't sure why joint replacement may increase the risk of heart attacks. But he thinks it may have something to do with a loss of "hemodynamic balance." That's the disruption of blood flow and blood oxygen during surgery. It can stress the heart.

"In high-risk patients, our study shows we need new strategies to prevent these heart attacks," Lalmohamed says in an email to WebMD.

Reducing the Risk of Heart Attacks After Joint Replacement

Matthew Hepinstall, MD, an orthopaedic surgeon at Lenox Hill Hospital in New York City, says the results of the study aren't really that surprising. He says doctors have long understood that major surgery can raise heart risks for vulnerable patients.

Hepinstall says the real benefit of the study is that it helps doctors recognize patients who may be at increased risk of a heart attack.

"This is elective surgery we're talking about," says Hepinstall, who was not involved in the research. "For the most part, these are people with arthritis choosing to have surgery for a quality-of-life issue."

That's why it's important to make sure that patients are healthy enough to have major surgery in the first place.

"We need to think very seriously about elective surgery in patients who are over age 80, with known heart disease or who have had a heart attack within the past year," Hepinstall says, since those were the patients at highest risk of heart attacks in the study.

Additionally, he says, the study helps to define a window for when joint replacement patients need to be most closely watched. That window is six weeks after surgery in hip replacement patients and up to two weeks after surgery for those who have their knees replaced.

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