Science/Tech

History Of Stroke May Increase Risk Of Adverse Surgical Complications, Even For Non-Cardiac Procedures

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Having surgery too soon after experiencing a stroke may put you at risk for adverse cardiovascular events. Photo courtesy of Shutterstock

Researchers from the University of Copenhagen in Denmark have found that individuals with a history of stroke who undergo elective non-cardiac surgery are at a significantly increased risk of major adverse heart problems and even death. This risk is largely dependent on the amount of time between stroke and surgery.

Doctors have already known that compared to patients with less recent heart attacks or stent implantation, patients who have had these health complications more recently are at increased risk for heart problems, blood clots, and bleeding. This recent study presents concrete evidence that similar time-dependent health risks also exist in patients with prior strokes. "Our findings need to be confirmed but may warrant consideration in future perioperative guidelines," the authors explained in a recent press release. It will be published tomorrow in the online journal JAMA.

The study involved data collected from 480,000 patients. It was found that the risk for adverse hard events was at it highest when the time between stroke and surgery was less than nine months. Without taking time into perspective, surgery following a history of stroke was found to increase the risk of 30-day mortality between 1.8 percent and 30-day major adverse cardiovascular events (MACE) by 4.8 percent. The most adverse outcomes were found to occur when there was less than three months in between stroke and surgery, and after nine months this risk appeared to be stable but still higher than patients with no stroke history. This risk was also found to be the same in patients with low and intermediate risk surgeries as it was in patients with high-risk surgeries. Information gathered from this study may be used to help develop better recommendations for surgery timing in order to avoid the risk of patient harm.

A stroke occurs when the blood supply to part of the brain is interrupted or severely reduced. This deprives the brain of oxygen and causes cells to immediately start to die. Obesity, physical inactivity, heavy drinking, and drug use will increase you risks of experiencing a stroke. About 85 percent of strokes are known as ischemic strokes. These occur when the arteries of your brain become narrow or are blocked completely. The result is severely reduced blood flow, also known as ischemia.

Major adverse cardiovascular events included in this study were conditions such as acute myocardial infarction, also known as a heart attack, ischemic strokes, cardiovascular arterial occlusion, which is the partial or complete obstruction of blood flow in a coronary artery, and cardiovascular death.

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