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Heart Damage Due To Vascular Surgery Increases Death Rates

According to a study, patients who have heart damage after vascular surgery are at high risk of death within the next few years, even if they show no symptoms of heart problems.

The researchers reported that lack of symptoms is common.

The study in which vascular surgery was performed on 1,545 people, 284 were found to have heart damage after surgery. However, the study found that 75 percent of them were either asymptomatic or their symptoms were masked by postoperative pain or nausea.

The study was to be presented at the annual meeting of the Society for Vascular Surgery in Denver.

The cardiac troponin T (cTnT) levels were studied of the study participants one, three and seven days after their surgery and when they were discharged. An elevated levels of cTnT which is a protein key to cardiac muscle contraction indicates heart damage.

Researchers noted that after surgery, heart damage was found to have occurred in 213 people who showed no symptoms and 71 who had symptoms.

Patients undergoing major arterial vascular surgery because of atherosclerotic disease are at high-risk for cardiac complications in the perioperative period, Dr. Olaf Schouten of the Erasmus Medical Center of Rotterdam, the Netherlands, said in a news release from the society.

It is estimated that one out of five patients undergoing major vascular surgery suffers cardiac damage around the time of the operation if patients are appropriately screened in the first week after surgery, Schouten added. Screening is a valuable tool to determine how aggressive medical therapy should be for their long-term prognosis.

During 3.7 years of follow-up, 40 percent of those with asymptomatic cardiac damage died, compared with 13 percent of people without cardiac damage. The study showed that after adjusting for the type of surgery and known risk factors such as diabetes, heart failure and heart attacks, there was more than twice as likely the risk of dying in people with cardiac damage in the years shortly after surgery.

Asymptomatic cTnT release, without clinical symptoms or new ECG changes, is associated with an increased long-term mortality in patients undergoing vascular surgery, Schouten concluded.