Surgery poses cardiac risk to lupus women

By Piriya Mahendra, medwireNews Reporter

Women with systemic lupus erythematosus (SLE) are at significantly increased risk for short-term perioperative adverse cardiovascular (CV) events, find researchers.

These findings highlight a need for greater scrutiny during perioperative evaluation and management of women with SLE, report Ali Yazdanyar (The Reading Hospital and Medical Center, Philadelphia, USA) and co-authors.

The cross-sectional analysis of pooled hospital discharge data from 1992 to 2002 of the National Inpatient Sample showed that all-cause mortality was significantly greater among women with SLE who had a low or high cardiac risk principal procedure (odds ratios=1.54 and 2.52, respectively) compared with those without SLE.

Principal procedures were categorized as low-, intermediate-, or high-risk for cardiac events based on American College of Cardiology/American Heart Association guidelines. Endoscopic, ophthalmologic, and breast procedures were categorized as low-risk, while orthopedic and intra-abdominal procedures were intermediate-risk.

High-risk procedures included peripheral vascular surgery with the exception of carotid endarterectomy and noncardiac procedures within the cardiothoracic cavity.

All-cause mortality did not differ significantly between women with and without SLE had intermediate-risk procedures.

But women with SLE who underwent a low-risk surgical procedure were a significant 40% more likely to experience a composite CV event (acute myocardial infarction [MI], non-ST elevation MI, congestive heart failure with pulmonary edema, and/or cerebrovascular accident) than those without SLE.

The study included 5,267,588 elective hospitalizations with a noncardiac principal procedure among women with and without SLE, of whom 3,640,994 were categorized as low-, 1,513,596 as intermediate-, and 112,997 as high-risk procedures.

"The perioperative setting represents a time of heightened risk for morbidity and mortality, especially in individuals at increased risk of CVD," write Yazdanyar et al in Arthritis Care & Research.

They conclude: "The results of our study, which revealed an increased risk of adverse perioperative events in women with SLE, indicate a need for greater scrutiny in perioperative clinical care in addition to further investigation as to the non-CV causes of increased perioperative mortality observed in women with SLE."

Licensed from medwireNews with permission from Springer Healthcare Ltd. ©Springer Healthcare Ltd. All rights reserved. Neither of these parties endorse or recommend any commercial products, services, or equipment.


The opinions expressed here are the views of the writer and do not necessarily reflect the views and opinions of News-Medical.Net.
Post a new comment
You might also like... ×
Facial injuries related to cell phones have risen steeply