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

Abstract

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. 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. 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. 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. III.