Feng B et al. – This study evaluated postoperative 90–day complications of total joint arthroplasty (TJA) in coronary artery disease (CAD) patients with a history of coronary artery revascularization and studied the risk factors for cardiac complications. The authors concluded that there is an increased risk of cardiac complications within 90 days postoperation among TJA patients with a history of CAD. The risk of cardiac complications after TJA for CAD patients cannot be significantly reduced by coronary artery revascularization; however, the risk decreases as the interval between revascularization and TJA increases.

Methods

• A retrospective analysis was performed on a total of 4414 patients and multivariate logistic regression was performed to identify the factors that predicted cardiac complications within 90 days postoperation.
• Sixty–four patients, all of whom had a history of myocardial infarction (MI), underwent cardiac revascularization and 201 CAD patients underwent medical therapy other than revascularization.

Results

• The incidence of cardiac complications within 90 days for the CAD with revascularization and history of MI group was 18.7%, 18.4% for the CAD without revascularization group, and 2.0% for the non–CAD group.
• The factors associated with a higher risk of cardiac complications included a history of CAD and revascularization, bilateral TJA, general anesthesia, body mass index ≥30 kg/m2, and history of MI.
• The risk of cardiac complications was also significantly higher in patients who underwent TJA within 2 years after cardiac revascularization and the risk decreased with time.