High Mortal Risk in Rheumatoid Arthritis Following Arthroplasty Save

Rheumatoid arthritis (RA) is associated with an increased risk of myocardial infarction (MI) and post-MI fatality compared with the general population. At issue is whether this applies to those undergoing a surgical procedure.

RA patients undergoing hip or knee arthroplasty (n=3654) were compared to non-RA arthoplasty patients.  RA patients had a higher risk of post-surgical MI (odds ratio 1.50; 95%CI 0.96–2.33), all-cause death (OR 1.85; 1.09–3.13) and cardiovascular death (OR 1.90; 1.07–3.37) at 6 weeks. There was a nonsignificant trend at 12 months for post joint surgery MI (OR 1.70; 1.27–2.28), all-cause death (OR 2.18;1.66–2.86) and cardiovascular death (OR 2.30; 1.65–3.22) in RA patients. These risks were no more significant when doing subanalyses on either hip or knee arthroplasty in people with RA.

Following joint surgery for RA, there appears to be a short-term increased risk of death at 6 weeks. The reasons for this remain to be elucidated, but in the meantime, RA patients should be considered at higher risk in the perioperative period.