Myocardial ischaemia after hip and knee arthroplasty: incidence and risk factors

Purpose: Because the occurrence of postoperative myocardial ischaemia (MI) predicts subsequent cardiac morbidity and mortality, we determined the prevalence of and risk factors for MI in hip and knee arthroplasty patients. Methods: High-sensitivity cardiac troponin T (hs-cTnT) was measured on stored samples from postoperative day two in 394 hip and knee arthroplasty patients ≥ 65 years of age enrolled in the Genetics-InFormatics Trial (GIFT). Results: Fifty-three (13.5 %) participants had MI, of whom only three were diagnosed clinically during their hospitalisation. The risk of MI increased with age [odds ratio (OR) 3.52 per decade, 95 % confidence interval (CI) 2.00–6.19] and diabetes (OR 2.23, 95 % CI 1.04–4.77). MI was rarer with statins (OR 0.74, 95 % CI 0.40–1.35) and more common with hypertension, coronary artery disease and tobacco use, although these were not statistically significant. Conclusions: Subclinical MI occurs frequently after arthroplasty. Diabetic and elderly patients are at highest risk.