title: Myocardial ischaemia after hip and knee arthroplasty: incidence and risk factors.
abstract: OBJECTIVE
  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.
authors.affiliation: Division of Rheumatology, Department of Medicine, Hospital for Special Surgery, Weill Cornell Medical College, 535 E 70th Street, New York, NY, 10021, USA. BassA@hss.edu.
authors.forename: Anne Ruth
authors.initials: AR
authors.lastname: Bass
authors.affiliation: Washington University School of Medicine in St. Louis, 660 S. Euclid Ave., St. Louis, MO, 63110, USA.
authors.forename: Tomás
authors.initials: T
authors.lastname: Rodriguez
authors.affiliation: Washington University School of Medicine in St. Louis, 660 S. Euclid Ave., St. Louis, MO, 63110, USA.
authors.forename: Gina
authors.initials: G
authors.lastname: Hyun
authors.affiliation: Clinical and Translational Science Center, Weill Cornell Medical College, 525 East 68th Street, Room A-150, New York, NY, 10065, USA.
authors.forename: Francisco Gerardo
authors.initials: FG
authors.lastname: Santiago
authors.affiliation: New York University School of Medicine, 550 1st Avenue, New York, NY, 10016, USA.
authors.forename: Jacqueline Ilji
authors.initials: JI
authors.lastname: Kim
authors.affiliation: Intermountain Medical Center, University of Utah School of Medicine, PO Box 57700, Murray, UT, 84157-7000, USA.
authors.forename: Scott Christopher
authors.initials: SC
authors.lastname: Woller
authors.affiliation: Washington University School of Medicine in St. Louis, 660 S. Euclid Ave., St. Louis, MO, 63110, USA.
authors.forename: Brian Foster
authors.initials: BF
authors.lastname: Gage
mesh_terms: D000367:Age Factors; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D048909:Diabetes Complications / Q000150:complications; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D017202:Myocardial Ischemia / Q000453:epidemiology* / Q000209:etiology; D015995:Prevalence; D012307:Risk Factors
keywords: Arthroplasty; Myocardial ischaemia; Postoperative complication; Risk factor; Statin; Troponin