Doctors Find Key Precursors of Heart Attacks

San Francisco researchers have identified five major traits that they say predict which patients who undergo non-heart surgery are most likely to be stricken with heart attacks after they go home.

The nation spends $22 billion annually to treat cardiac complications after operations ranging from blood vessel repairs to hip replacements, researchers said. Each year, 50,000 people suffer heart attacks after non-heart operations.

But little long-term research has focused on such patients.

“Finally, we may be able to get a handle on this problem of heart attacks and surgery. It’s a problem that’s been with us for a long time,” said Dr. Dennis T. Mangano of the Veterans Affairs Medical Center in San Francisco.

He and colleagues at the Veterans Administration and UC San Francisco have written five studies on the subject appearing in today’s Journal of the American Medical Assn.

One study, a two-year follow-up of 444 patients who were released in stable condition after non-heart operations, found the key trait that predicted heart problems was a condition called ischemia--an inadequate supply of blood to the heart, Mangano said.

A second trait was a heart attack or severe heart pain while still in the hospital. Over the next two years, patients who suffered heart pain were 20 times more likely to die of heart disease or suffer another heart attack.

Other traits that predicted complications were blood vessel disease, congestive heart failure and coronary artery disease. Some heart problems, including temporary heart-rhythm irregularities and rapid heartbeat after surgery were not predictive of heart attacks.