Study suggests new surgical guidelines could help reduce risks
Before undergoing elective surgery, patients should consider waiting longer after a heart attack than is currently recommended, according to a study scheduled for publication in the May issue of the journal, Annals of Surgery.
The American Heart Association and the American College of Cardiology recommend patients wait at least four to six weeks after a heart attack before undergoing elective surgery. This guidance is based on studies conducted in the 1970s and 1980s.
The new study examined surgical outcomes among more than 550,000 California patients over a five-year period (1999-2004) who underwent five common elective surgeries after a heart attack. Researchers found substantially lower death rates and fewer subsequent heart attacks in those who waited eight or more weeks after a heart attack to undergo hip surgery, gallbladder removal, non-traumatic amputation, colon resection or elective abdominal aortic aneurysm repair.
"Despite medical advancements in the treatment of coronary artery disease today, a recent heart attack remains a very important risk factor for patients undergoing surgery," said Christian de Virgilio, MD, the study's corresponding author and a principal investigator at Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center (LA BioMed). "Our study suggests that patients should wait at least eight weeks after a heart attack before undergoing elective surgery. The results of the study also reignite the question of whether, in this high risk group, physicians should consider coronary artery stenting or bypass prior to elective surgery."