Cardiovascular and Cerebrovascular Events Are Associated With Nontraumatic Osteonecrosis of the Femoral Head

Sung, Pei‐Hsun; Chiang, Hsin‐Ju; Chiang, John Y.; Chen, Chi-Jen; Yip, Hon‐Kan; Lee, Mel S.

doi:10.1007/s11999.0000000000000161

Cited by 18 publications

(16 citation statements)

References 26 publications

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“…The underlying mechanism is thought to be related to the endothelial dysfunction. In the former study [14], the ONFH patients were found to have about twice increased risk for MACCE even after multivariate adjustment for medications, surgery and relevant comorbidities. The latter study was aimed to find the incidence of unprovoked VTE in non-traumatic ONFH [20].…”

Section: Discussionmentioning

confidence: 90%

“…Short-term or long-term administration of NSAID protected ONFH patients from postoperative VTE was noted in the present study. Also, data from the previous two studies [14,20] have documented that NSAID has the protective effects against not only provoked VTE but also MACCE in patients with nontraumatic ONFH. Although most early researches have shown the use of non-selective NSAID strongly leads to endothelial dysfunction and links to arterial/venous thrombotic complications [27,28], yet more and more recent meta-analyses have challenged the cardiovascular safety issue of NSAID, especially cyclooxygenase-2 (COX-2) selective inhibitor [29,30].…”

Section: Discussionmentioning

confidence: 96%

“…Two previous clinical observational researches to investigate the association between ONFH and cardiovascular diseases [14,20] have shown positive results that both major adverse cardiovascular or cerebrovascular events (MACCE) and VTE were significantly increased in the ONFH population as compared with the general population. The underlying mechanism is thought to be related to the endothelial dysfunction.…”

Section: Discussionmentioning

confidence: 99%

“…The disease mechanisms of ONFH are often considered as multifactorial, including trauma, drug, surgery, and idiopathic causes [1,10,11]. Recently, growing evidence has shown that endothelial dysfunction related inappropriate nitric oxide production may be one of the key causative factors for ONFH [12][13][14][15][16]. Endothelial cell injury or dysfunction is well known as one of the fundamental risk factors for venous thromboembolic events (VTE) [17].…”

Section: Introductionmentioning

confidence: 99%

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Risk of Venous Thromboembolic Events in Patients with Osteonecrosis of the Femoral Head Undergoing Primary Hip Arthroplasty

Sung

Yang

Chiang

et al. 2019

JCM

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Previous data have shown patients with osteonecrosis of the femoral head (ONFH) have increased lifelong risk of unprovoked venous thromboembolic events (VTE) as compared with the general population, according to sharing common pathological mechanism of endothelial dysfunction. However, whether the risk of VTE increases in those ONFH patients undergoing major hip replacement surgery remains unclear. This is a retrospective nationwide Asian population-based study. From 1997 to 2013, a total of 12,232 ONFH patients receiving partial or total hip replacement for the first time and revision surgeries were retrospectively selected from Taiwan Health Insurance surgical files. By 1:1 matching on age, sex, surgical types, and socioeconomic status, 12,232 subjects without ONFH undergoing similar hip surgery were selected as non-ONFH group. The incidence and risk of post-surgery VTE, including deep venous thrombosis (DVT) and pulmonary embolism (PE), were compared between the ONFH and non-ONFH groups. Results showed that 53.8% of ONFH patients were male and the median age was 61.9 years old. During the mean follow-up period of 6.4 years, the incidences of VTE (1.4% vs. 1.2%), DVT (1.1% vs. 0.9%), and PE (0.4% vs. 0.4%) were slightly but insignificantly higher in the ONFH than in the non-ONFH group undergoing the same types of major hip replacement surgery (all p-values > 0.250). Concordantly, we found no evidence that the risk of VTE was increased in the ONFH patients as compared with the non-ONFH counterparts (adjusted HR 1.14; 95% CI 0.91–1.42; p = 0.262). There were also no increased risks for DVT and PE in the ONFH subgroups stratified by comorbidities, drug exposure to pain-killer or steroid, and follow-up duration after surgery, either. In conclusion, hip arthroplasty in Asian patients with ONFH is associated with similar rates of VTE as compared to patients with non-ONFH diagnoses.

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Risk of Venous Thromboembolic Events in Patients with Osteonecrosis of the Femoral Head Undergoing Primary Hip Arthroplasty

Sung

Yang

Chiang

et al. 2019

JCM

Self Cite

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“…However, the mechanism leading to these metabolic changes as a result of the viral infection remains unknown. Osteonecrosis is independently associated with an increased risk of adverse CV outcomes in SARS patients treated with corticosteroids and warrants further exploration [98,99]. Psychiatric morbidities, including chronic fatigue syndrome, were also reported in patients who recovered from SARS [100].…”

Section: Future Complications and Implicationsmentioning

confidence: 99%

COVID-19 Pandemic: Cardiovascular Complications and Future Implications

Bandyopadhyay

Akhtar

Hajra

et al. 2020

Am J Cardiovasc Drugs

112

103

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Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is now a global pandemic with the highest number of affected individuals in the modern era. Not only is the infection inflicting significant morbidity and mortality, but there has also been a significant strain to the health care system and the economy. COVID-19 typically presents as viral pneumonia, occasionally leading to acute respiratory distress syndrome (ARDS) and death. However, emerging evidence suggests that it has a significant impact on the cardiovascular (CV) system by direct myocardial damage, severe systemic inflammatory response, hypoxia, right heart strain secondary to ARDS and lung injury, and plaque rupture secondary to inflammation. Primary cardiac manifestations include acute myocarditis, myocardial infarction, arrhythmia, and abnormal clotting. Several consensus documents have been released to help manage CV disease during this pandemic. In this review, we summarize key cardiac manifestations, their management, and future implications. Dhrubajyoti Bandyopadhyay, Adrija Hajra and Srihari S. Naidu contributed equally.

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Effects of malnutrition on outcomes of patients with femoral head osteonecrosis undergoing total hip arthroplasty: A population‐based study

Chuang¹,

Yeh²,

Hung³

et al. 2023

Nut in Clin Prac

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BackgroundThis study aimed to evaluate the impact of malnutrition on in‐hospital outcomes in patients undergoing total hip arthroplasty (THA) for osteonecrosis of the femoral head (ONFH).MethodsThis population‐based retrospective study extracted data of patients undergoing THA for ONFH in the US National Inpatient Sample between 2005 and 2018. Factors associated with in‐hospital mortality, medical and surgical complications, unfavorable discharge, and prolonged hospital stay were determined by logistic regression analysis.ResultsA total of 72,304 adults ≥18 years old with nontraumatic ONFH admitted for primary THA were included. Malnutrition was detected in 7152 (9.9%) patients using validated discharge codes. In‐hospital mortality was 0.8% vs 0.1% for patients who were malnourished vs nonmalnourished. After adjusting for confounders, malnutrition was significantly associated with an increased risk of in‐hospital death (adjusted odds ratio [aOR], 4.67; 95% CI, 2.43–8.97), medical complications (aOR, 1.49; 95% CI, 1.32–1.68), surgical complications (aOR, 1.78; 95% CI, 1.61–1.96), unfavorable discharge (aOR, 1.24; 95% CI, 1.11–1.39), and prolonged hospital stay (aOR, 1.90; 95% CI, 1.67–2.16) compared with adequate nutrition. Malnutrition was also associated with higher total hospital costs (adjusted β = $9620; 95% CI, 7.87–11.36). Furthermore, the association between malnutrition, any medical or surgical complications, and unfavorable discharge was stronger in patients younger than 50 years than those ≥50 years old.ConclusionsIn US patients undergoing primary THA for ONFH, malnutrition increases the risk of unfavorable in‐hospital outcomes. This patient subgroup may require special attention and better strategies to improve perioperative care.

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Cardiovascular and Cerebrovascular Events Are Associated With Nontraumatic Osteonecrosis of the Femoral Head

Abstract: Level III, prognostic study.

Cited by 18 publications

References 26 publications

Risk of Venous Thromboembolic Events in Patients with Osteonecrosis of the Femoral Head Undergoing Primary Hip Arthroplasty

Risk of Venous Thromboembolic Events in Patients with Osteonecrosis of the Femoral Head Undergoing Primary Hip Arthroplasty

COVID-19 Pandemic: Cardiovascular Complications and Future Implications

Effects of malnutrition on outcomes of patients with femoral head osteonecrosis undergoing total hip arthroplasty: A population‐based study

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