bannerHON
img
HONnews
HONnews
img PATIENT / PARTICULIER img PROFESSIONNEL DE SANTE img WEBMESTRE img
img
 
img
HONcode sites
Khresmoi - new !
HONselect
News
Conferences
Images

Themes:
A B C D E F G H I
J K L M N O P Q
R S T U V W X Y Z
Browse archive:
2017: D N O S A J J M A M F J
2016: D

 
  Other news for:
Surgery
 Resources from HONselect
Even Non-Heart Surgery May Harm Your Heart

By Amy Norton
HealthDay Reporter

MONDAY, Dec. 4, 2017 (HealthDay News) -- Older adults commonly suffer damage to heart cells during various types of surgery -- even non-heart-related surgeries -- and it can significantly raise their risk of dying from the procedure, a new study finds.

The research looked at a phenomenon called perioperative myocardial injury, or PMI. It refers to subtler heart damage that can happen during or soon after any type of surgery.

Older patients and those who already have heart disease are at increased risk.

However, the condition is easily missed because most of the affected patients have no chest pain or other symptoms, according to Dr. Christian Puelacher, the first author on the new study. He's a clinical researcher at Cardiovascular Research Institute Basel in Switzerland.

Puelacher's team found that PMI may happen more often than doctors have typically thought: Of more than 2,000 high-risk patients they screened, 1 in 7 developed PMI after a non-cardiac surgery, the study found.

"This suggests we've underestimated the number of myocardial [heart] injuries that occur during non-cardiac surgery," said Dr. Alistair Phillips, co-chair of the surgeons' section leadership council for the American College of Cardiology.

The cases were found because all of the patients -- treated at the University Hospital Basel in Switzerland -- were screened for PMI with a newer blood test: a so-called "high sensitivity" troponin test, which detects elevations in the heart protein troponin.

When troponin levels rise, it's a sign of heart damage, Phillips explained.

High-sensitivity troponin tests have been used in Europe and elsewhere for several years, but have only recently become available in the United States. The U.S. Food and Drug Administration approved the first such test earlier this year.

Phillips, who was not involved with the study, said that as such testing comes into wider use, doctors will be able to better manage patients who develop PMI.

The findings are based on more than 2,000 patients who underwent non-cardiac procedures ranging from knee and prostate surgeries to hip replacements and gallbladder removal.

All of the patients had their troponin levels measured before and after surgery because they were considered high-risk for PMI: They were either older than 65, or had a history of heart disease, stroke or peripheral artery disease (clogged leg arteries).

Overall, 1 in 7 developed PMI. And those patients had a six times higher death rate in the 30 days after surgery: 9 percent died, versus only 1.5 percent of patients without PMI.

Most often, the study found, patients had no telltale signs of heart damage. Only 6 percent had chest pain, while 18 percent had any symptoms to signal that blood and oxygen flow to the heart was being impaired.

According to Puelacher, the findings offer some "first hints" that systematic screening for PMI can benefit patients.

There is no single PMI treatment. "Responses need to be tailored," Puelacher said. "PMI can have a range of causes and the management strategy needs to be chosen appropriately."

That could mean medication, Phillips said -- using a beta blocker to control a patient's heart rate, for example, or prescribing a statin.

Doctors could also screen for coronary heart disease (blocked heart arteries) in patients who have never been diagnosed with it, Puelacher said.

No one is saying older patients, or those with heart disease, should avoid a needed surgery.

According to Phillips, the message is positive rather than "alarming."

"We now have a new tool that should help us better screen patients post-surgery," he said.

The research does not address the question of whether some patients should avoid an elective procedure in the first place, according to Puelacher.

All of the study patients, he said, were cleared for surgery after a thorough evaluation.

"Preoperative evaluation is usually done very thoroughly in routine clinical practice, taking into account risk factors such as heart disease," Puelacher said.

"Our data," he added, "suggest an option [for] improving care and outcomes after a surgery has taken place."

The study findings were published in the Dec. 4 online issue of the journal Circulation.

More information

The American Heart Association has advice on recovering from surgery.

SOURCES: Christian Puelacher, M.D., Ph.D., clinical researcher, Cardiovascular Research Institute Basel, Switzerland; Alistair Phillips, M.D., co-chair, Surgeons' Section Leadership Council, American College of Cardiology, Washington, D.C.; Dec. 4, 2017, Circulation, online

Copyright © 2017 HealthDay. All rights reserved. URL:http://consumer.healthday.com/Article.asp?AID=729015

Resources from HONselect: HONselect is the HON's medical search engine. It retrieves scientific articles, images, conferences and web sites on the selected subject.
Heart
Heart Diseases
Methods
Risk
Arteries
Leadership
Blood
Pain
Chest Pain
The list of medical terms above are retrieved automatically from the article.

Disclaimer: The text presented on this page is not a substitute for professional medical advice. It is for your information only and may not represent your true individual medical situation. Do not hesitate to consult your healthcare provider if you have any questions or concerns. Do not use this information to diagnose or treat a health problem or disease without consulting a qualified healthcare professional.
Be advised that HealthDay articles are derived from various sources and may not reflect your own country regulations. The Health On the Net Foundation does not endorse opinions, products, or services that may appear in HealthDay articles.


Inicio img Sobre nosotros img Rincón de la prensa img Boletín HON img Mapa del sitio img Política ética img Contactos