The relation between total joint arthroplasty and risk for serious cardiovascular events in patients with moderate-severe osteoarthritis: propensity score matched landmark analysis

Objective To examine whether total joint arthroplasty of the hip and knee reduces the risk for serious cardiovascular events in patients with moderate-severe osteoarthritis.Design Propensity score matched landmark analysis.Setting Ontario, Canada.Participants 2200 adults with hip or knee osteoarthri...

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Bibliographic Details
Published in:BMJ (Online) 2013-10, Vol.347 (oct30 1), p.f6187-f6187
Main Authors: Ravi, Bheeshma, Croxford, Ruth, Austin, Peter C, Lipscombe, Lorraine, Bierman, Arlene S, Harvey, Paula J, Hawker, Gillian A
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Arthritis
Arthroplasty (hip)
Arthroplasty, Replacement, Hip - adverse effects
Arthroplasty, Replacement, Knee - adverse effects
Cardiovascular disease
Cardiovascular diseases
Cardiovascular Diseases - epidemiology
Case-Control Studies
Female
Follow-Up Studies
Health insurance
Health risk assessment
Hip
Humans
Joint surgery
Knee
Male
Middle Aged
Ontario - epidemiology
Osteoarthritis
Osteoarthritis, Hip - surgery
Osteoarthritis, Knee - surgery
Propensity Score
Prospective Studies
Risk Factors
Treatment Outcome
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Summary:Objective To examine whether total joint arthroplasty of the hip and knee reduces the risk for serious cardiovascular events in patients with moderate-severe osteoarthritis.Design Propensity score matched landmark analysis.Setting Ontario, Canada.Participants 2200 adults with hip or knee osteoarthritis aged 55 or more at recruitment (1996-98) and followed prospectively until death or 2011.Main outcome measure Rates of serious cardiovascular events for those who received a primary total joint arthroplasty compared with those did not within an exposure period of three years after baseline assessment.Results The propensity score matched cohort consisted of 153 matched pairs of participants with moderate-severe arthritis. Over a median follow-up period of seven years after the landmark date (start of the study), matched participants who underwent a total joint arthroplasty during the exposure period were significantly less likely than those who did not to experience a cardiovascular event (hazards ratio 0.56, 95% confidence interval 0.43 to 0.74, P
ISSN:0959-8138
1756-1833
0959-8146
1756-1833
DOI:10.1136/bmj.f6187