Specialist Heart Doctors May Prevent Post-Surgery Deaths and Disease

A new study, published in the European Heart Journal, indicates that involving specialist heart doctors in post-surgery care for some patients could prevent deaths and serious heart disease. Annually, an estimated 4.2 million people worldwide die within 30 days of surgery.

Involving specialist heart doctors in post-surgery care for some patients could prevent deaths and serious heart disease.

Study Details

Researchers Dr. Christian Puelacher, Dr. Noemi Glarner, and a team from the University of Basel, Switzerland, conducted an observational study. They examined 14,294 high-risk patients undergoing non-cardiac surgery in Switzerland. High-risk patients were defined as those aged 65 or older or with pre-existing cardiovascular disease.

The study focused on 1,048 patients who experienced perioperative myocardial infarction/injury (PMI), or heart damage, identified through blood tests for troponin levels after their operations. Of these, 614 patients (58.6%) were evaluated by a cardiologist on the surgical ward, while 434 (41.4%) were not, often due to specialist unavailability during weekends or public holidays.

Key Findings

Comparing the two groups, the study observed the following for patients seen by a cardiologist:

• They were 35% less likely to die within one year following surgery.
• They were 46% less likely to suffer any serious heart problems, including heart attack, sudden heart failure, dangerously irregular heart rhythm, or death from heart disease.
• These patients also received more heart imaging tests and were prescribed stronger medications.

Patients seen by a cardiologist were 35% less likely to die within one year following surgery.

Dr. Puelacher stated that the study associates cardiologist involvement in a patient's care after PMI with fewer serious heart problems and improved one-year survival. Dr. Glarner noted that while the observational nature of the study prevents establishing direct cause-and-effect, it provides significant findings.

Expert Commentary and Future Work

Professor William Weintraub and colleagues from Georgetown University, Washington D.C., in an accompanying editorial, described the study as valuable for addressing a potentially modifiable management issue in patients with post-surgical PMI. They acknowledged the rigorous data collection and statistical analysis but highlighted the inherent limitations of observational studies regarding unmeasured confounding variables.

A cardiology consult in the context of post-surgical PMI might offer clinical benefits, citing no evidence of harm.

The editorial provisionally concluded that a cardiology consult in the context of post-surgical PMI might offer clinical benefits, citing no evidence of harm. Researchers are currently conducting an implementation study for PMI screening in hospitals across Switzerland and Austria.