Complications of Total Joint Arthroplasty in Patients Who Have a History of Coronary Artery Bypass Graft: A Propensity-Matched Cohort Study Publisher Pubmed



Ah Hoveidaei Amir HUMAN ; S Esmaeili SINA ; H Ghasemi HOOMAAN ; N Abiri Jahromi NEGIN ; M Poursalehian MOHAMMAD ; M Mahalleh MEHRDAD ; Sj Suresh Sukrit JUSHAY ; Jd Conway Janet D
Source: Journal of Arthroplasty Published:2025

Abstract

Background: The literature is scarce regarding potential adverse events in patients who have a history of coronary artery bypass graft (CABG) who underwent total joint arthroplasty. The current study aimed to evaluate postoperative complications in this population. Methods: This retrospective cohort study used a national database (2010 to 2022) to examine postoperative outcomes in patients who underwent total hip arthroplasty or total knee arthroplasty and who had or did not have a history of CABG surgery within 3 years before arthroplasty. Outcomes of interest included myocardial infarction (MI), cerebrovascular accident (CVA), venous thromboembolism, acute renal failure, readmission, transfusion, surgical site infection, periprosthetic joint infection, periprosthetic fracture, and all-cause revision. Propensity score matching was used to control for baseline differences, and multivariate logistic regression was conducted to assess CABG as an independent predictor of postoperative complications. Results: Patients who had a history of CABG before total hip arthroplasty demonstrated significantly higher rates of MI (odds ratio [OR], 2.46; P < 0.001), CVA (OR, 1.36; P = 0.027), and readmission (OR, 1.42; P < 0.001) compared to controls. Similarly, among total knee arthroplasty patients, CABG was associated with increased MI (OR, 2.37; P < 0.001) and CVA rates (1.26; P = 0.049). No significant differences were observed regarding surgical site infection, periprosthetic joint infection, periprosthetic fracture, acute renal failure, transfusion rates, or revision rates between CABG and matched control groups. Conclusions: Patients who have a history of CABG may have an increased risk of adverse cardiovascular events following total joint arthroplasty, necessitating more intensive postoperative cardiovascular monitoring and care. Level of Evidence: III © 2025 Elsevier B.V., All rights reserved.