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Risk Factors for In-Hospital Myocardial Infarction After Shoulder Arthroplasty

The American Journal of Orthopedics. 2015 May;44(5):E142-E147
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As cardiovascular complications are associated with significant morbidity and mortality in patients who have arthroplasty, it is important to analyze risk factors for perioperative cardiac morbidity after shoulder arthroplasty.

Using the Nationwide Inpatient Sample, we stratified patients who underwent shoulder arthroplasty into those who had an acute myocardial infarction after arthroplasty and a larger cohort of patients who did not. The top 4 predictors for acute myocardial infarction after shoulder arthroplasty were congestive heart failure, angina pectoris, complicated diabetes mellitus, and male sex. Other pertinent factors were older age, Caucasian ethnicity, and primary diagnosis of proximal humerus fracture.

It is prudent for surgeons and patients to understand the degree to which perioperative cardiac morbidity affects surgical recovery.

Conclusion

The top 4 predictors for acute MI after shoulder arthroplasty were congestive heart failure, angina pectoralis, complicated diabetes mellitus, and male sex. Other pertinent risk factors included older age, Caucasian ethnicity, and primary diagnosis of proximal humerus fracture. Surgeons and patients must be aware of predictors for adverse surgical outcomes such as perioperative MI and understand the extent to which these events increase perioperative morbidity and mortality.