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Increased Long-Term Cardiovascular Risk After Total Hip Arthroplasty A Nationwide Cohort Study
Karolinska Inst, Danderyd Hosp, Dept Clin Sci, Stockholm, Sweden..
Karolinska Inst, Danderyd Hosp, Dept Clin Sci, Stockholm, Sweden..
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics.
Registerctr VGR, Swedish Hip Arthroplasty Register, Gothenburg, Sweden.;Univ Gothenburg, Sahlgrenska Acad, Dept Orthoped, Inst Clin Sci, Gothenburg, Sweden.;Massachusetts Gen Hosp, Harris Orthoped Lab, Boston, MA 02114 USA.;Harvard Univ, Sch Med, Boston, MA USA..
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2016 (English)In: Medicine (Baltimore, Md.), ISSN 0025-7974, E-ISSN 1536-5964, Vol. 95, no 6, 1-7 p.Article in journal (Refereed) Published
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Abstract [en]

Total hip arthroplasty is a common and important treatment for osteoarthritis patients. Long-term cardiovascular effects elicited by osteoarthritis or the implant itself remain unknown. The purpose of the present study was to determine if there is an increased risk of late cardiovascular mortality and morbidity after total hip arthroplasty surgery. A nationwide matched cohort study with data on 91,527 osteoarthritis patients operated on, obtained from the Swedish Hip Arthroplasty Register. A control cohort (n = 270,688) from the general Swedish population was matched 1:3 to each case by sex, age, and residence. Mean follow-up time was 10 years (range, 7-21). The exposure was presence of a hip replacement for more than 5 years. The primary outcome was cardiovascular mortality after 5 years. Secondary outcomes were total mortality and re-admissions due to cardiovascular events. During the first 5 to 9 years, the arthroplasty cohort had a lower cardiovascular mortality risk compared with the control cohort. However, the risk in the arthroplasty cohort increased over time and was higher than in controls after 8.8 years (95% confidence interval [CI] 7.0-10.5). Between 9 and 13 years postoperatively, the hazard ratio was 1.11 (95% CI 1.05-1.17). Arthroplasty patients were also more frequently admitted to hospital for cardiovascular reasons compared with controls, with a rate ratio of 1.08 (95% CI 1.06-1.11). Patients with surgically treated osteoarthritis of the hip have an increased risk of cardiovascular morbidity and mortality many years after the operation when compared with controls.

Place, publisher, year, edition, pages
2016. Vol. 95, no 6, 1-7 p.
National Category
Orthopedics
Identifiers
URN: urn:nbn:se:uu:diva-282495DOI: 10.1097/MD.0000000000002662ISI: 000370654700001PubMedID: 26871792OAI: oai:DiVA.org:uu-282495DiVA: diva2:917088
Funder
Åke Wiberg FoundationStockholm County CouncilThe Karolinska Institutet's Research Foundation
Available from: 2016-04-05 Created: 2016-04-05 Last updated: 2017-11-30Bibliographically approved

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Garland, AnneHailer, Nils P.

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