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Heart Attacks More Common after Hip, Knee Replacement

July 24, 2012 — According to a new study published in the Archives of Internal Medicine, people over the age of 60 are up to 31-times more likely to have a heart attack in the two weeks after hip or knee replacement surgery. The risk for those over the age of 80 was especially high. The researchers said that elective hip replacement surgery should be contraindicated in patients who had a heart attack in the last 12 months.

The researchers analyzed hospital records for 95,000 people from Denmark who had a hip or knee replaced between 1998 and 2007. Each person’s records were compared to three people (286,165 people) of the same age and gender who did not undergo a hip or knee replacement.

During the first six weeks after the surgery, one in 200 hip replacement patients had a heart attack, and one in 500 knee replacement patients had a heart attack. This translates to a 31-fold increased risk of heart attack among knee replacement patients, and a 25-fold increased risk of heart attack among hip implant patients.

Doctors already know that these procedures have a high risk of heart attack, which is why patients are prescribed blood-thinning medications. Despite the medication, the elevated risk of heart attack persisted for six weeks after knee or hip replacement surgery.

It is likely that the surgery itself caused many of the heart attacks. When a surgeon cuts into bones, this promotes the formation of blood clots. Hip surgery carries a high risk of blood clots. Surgery and anesthesia also increase stress levels for patients, which is a known risk factor for a heart attack.

The researchers noted that other factors could have affected the results. For example, people who are obese are more likely to need a hip or knee replacement, and they are also more likely to have a heart attack. High blood pressure could also increase the risk of a heart attack.

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