A Swiss study published in the European Heart Journal suggests that a cardiology consultation after any surgery can reduce the risk of death and serious cardiac events within a year. Nearly 4.2 million people worldwide die within 30 days of surgery each year.
“With our ageing population, surgery is increasingly common. Even when surgery is not on the heart, the heart is challenged by the stress of surgery, including anaesthesia, blood loss, inflammation and changes in blood pressure. This can lead to perioperative myocardial infarction/injury, or PMI for short,” the researchers explained.
In high-risk patients, such as those with existing heart or blood vessel disease or people over age 65, about 15 per cent experience PMI. Although PMI often causes no symptoms, it substantially increases the risk of complications and death in the days and months following surgery.
The researchers studied 14,294 patients undergoing non-cardiac surgery. All were considered high risk for PMI because they were 65 or older or had pre-existing cardiovascular disease.
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After surgery, patients received a blood test measuring troponin, a protein released when the heart is damaged, such as during a heart attack. The analysis focused on 1,048 patients whose test results showed heart damage or a heart attack around the time of surgery.
Of these patients, 614 (58.6 per cent) were evaluated by a cardiologist, while 434 (41.4 per cent) were not.
Patients who saw a cardiologist were 35 per cent less likely to die within a year of surgery and 46 per cent less likely to experience serious heart-related events, including heart attack, acute heart failure, dangerous heart rhythm problems or death from heart disease. These patients were more likely to undergo heart imaging tests and receive more intensive heart medications.
Screening surgical patients for PMI is critical. “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. Our results suggest that close teamwork between surgical and heart teams can improve outcomes after major surgery,” the researchers said.