Simple test may help cut heart risk during surgery
It’s the injury to your heart that you — and your doctor — may never have seen coming.
While your surgeon may downplay the danger, there’s no doubt that surgery — of any kind — is risky.
And while I’m not trying to unnecessarily scare you if you need to have a procedure done, you should know that it could harm your heart.
A new study out of Switzerland that tested over 2,000 patients who underwent procedures such as knee, hip, gall bladder, and prostate surgery found that 1 in 7 were suffering from silent heart damage triggered by those operations.
That means most all of those patients had no telltale chest pains or other signs.
Another thing these researchers found: All it takes is a simple blood test to quickly tell if your heart is in jeopardy.
Heart damage waiting to happen
Some new research has found that nearly 20 percent of patients will suffer a “heart injury” from non-cardiac surgery, with over 90 percent of those cases going unrecognized.
One of the reasons post-operative heart disease may go unnoticed is that pain meds given after a surgical procedure can mask symptoms of heart problems. So, if you’re like many patients, you may not feel any symptoms at all.
Fortunately, the FDA has finally approved a blood test that’s much better at detecting exactly how much risk you might be taking — before you go under the knife.
That test can check for a condition called PMI, or perioperative myocardial injury, which is “subtle” heart damage that can occur during or shortly after surgery.
And that’s very important to know about — because if you have PMI, it puts you at a much bigger risk of dying after an operation.
PMI is detected by checking for a protein released into the blood after the heart is injured, called troponin.
In fact, that’s the first thing an ER doc looks for when someone goes to the hospital with chest pain to find out if they’ve suffered a heart attack. But, unlike the blood tests used in Europe for the past seven years, the tests available to U.S. doctors have been much less sensitive, causing a lot more precious time to go by before getting a result.
What this most recent study — from doctors out of the Cardiovascular Research Institute Basel in Switzerland — uncovered is that any surgical patient over 65, as well as anyone with a history of stroke or disease that restricts the blood flow in leg arteries, is at risk for PMI.
Plus that, they should not only be tested for elevated troponin after surgery… but before it as well.
This confirms research done earlier this year in the UK, which found that checking troponin levels before an operation could very well be the simplest way to determine which patients are at the greatest risk of dying in the year following surgery.
Shockingly, close to 40 percent of the patients in that study (who had not suffered a heart attack) with troponin levels of 50 ng/l or higher prior to surgery died during the following year.
As I said, while tests for elevated troponin are pretty much the gold standard in detecting a heart attack, the kind of subtler damage surgery might cause to your heart can only be found using a high-sensitivity troponin test — something you would have previously needed to go to Europe to get!
But finally, the FDA has approved a version of this test that’s much more sensitive at detecting these lower, but still heart-damaging, levels.
Now that we know the danger and have a better test available, there’s no reason in the world your doctor shouldn’t include this along with any pre-op clearance testing he may be doing.
By checking your troponin levels, your surgeon can tailor your treatment to make sure your heart is being protected as much as possible during, and after, any kind of surgery.
And while the results of this test might make you more anxious when it comes to your heart, knowing exactly what shape it’s in could be the best way to keep it ticking for many more years.
“Even non-heart surgery may harm your heart” Amy Norton, December 4, 2017, HealthDay, consumer.healthday.com
