Cardiologists should always be involved when heart issues arise after surgery
Cardiac complications after noncardiac surgeries are a significant concern, especially as patients keep living longer and surgical volumes keep rising. According to a new analysis published in European Heart Journal, getting cardiologists more involved in the treatment of such complications, particularly perioperative myocardial infarction/injury (PMI), could have a significant impact on patient outcomes.[1]
“Even when surgery is not on the heart, the heart is challenged by the stress of surgery, including anesthesia, blood loss, inflammation and changes in blood pressure,” co-author Christian Puelacher, MD, PhD, a researcher with University Hospital Basel in Switzerland, said in a statement. “In high-risk patients, such as those with pre-existing heart or vascular conditions, or those aged over 65, PMI occurs in approximately 15% of patients, usually without any symptoms. Despite its often-silent presentation, PMI is a strong predictor for complications and death in the days and months after surgery.”
Puelacher et al. reviewed data from more than 14,000 high-risk patients who underwent noncardiac surgery at one of two hospitals in Switzerland. All patients were either 65 years old or older or 45 years or older with a history of coronary artery disease, peripheral artery disease or stroke.
All patients were given cardiac troponin tests after surgery. These tests identified signs of PMI in more than 1,000 patients. While 58.6% of those patients were evaluated by a cardiologist, the remaining 41.4% were not.
Overall, PMI patients evaluated by a cardiologist were 35% less likely to die within one year of surgery and 46% less likely to suffer any significant cardiac complications within one year. Cardiac imaging was also more likely to be ordered for patients evaluated by a cardiologist.
“Our study shows that having a cardiologist involved in a patient’s care after PMI is associated with fewer serious heart problems and better survival one year later,” Puelacher said. “Our results suggest that close teamwork between surgical and heart teams can improve outcomes after major surgery.”
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Michael has more than 19 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.