35 percent fewer deaths thanks to cardiology care after operations

Every year, at least 4.2 million people worldwide die within 30 days of an operation. Heart attacks and other cardiac complications are among the most common causes. These so-called perioperative myocardial infarctions (PMI) are often asymptomatic and are therefore frequently overlooked in routine care.

Heart attack after surgery - an underestimated risk

Painkillers, anesthetic after-effects and the distraction of surgical wounds mask the typical warning signals such as chest pain or shortness of breath. "Without systematic screening using biomarkers, these life-threatening events usually go undetected in routine care," explains Dr. Noemi Glarner, first author and assistant physician at the University Hospital Basel. To make matters worse, cardiologists are not routinely involved in post-operative care in many hospitals. Surgeons concentrate on the surgical procedure, while the heart receives too little attention as a "silent patient".

Study with 14,294 high-risk patients and USB as an international pioneer

The University Hospital Basel was one of the first centers worldwide to establish a systematic monitoring and treatment program for PMI. The current study included 14,294 high-risk patients, 1,048 of whom suffered a perioperative myocardial infarction. 614 of these patients (59 percent) received a specialized cardiological evaluation - with clear results: After one year, there were significantly fewer serious cardiac events (46 percent) and deaths (35 percent) compared to the group without cardiology care. "The results impressively demonstrate that the close collaboration between surgery, anaesthesia and cardiology not only makes sense in theory, but also measurably saves lives," emphasizes Prof. Christian Müller, Head of Clinical Research at the University Hospital Basel. The cardiological assessment led to targeted diagnostic measures, optimized drug therapy and individually adapted treatment strategies. The Heart Center at the University Hospital Basel has been carrying out such examinations for 10 years.

Overcoming challenges with artificial intelligence and telemedicine

The study also shows that even in Switzerland, only 60 percent of those affected were able to undergo a cardiological evaluation - mainly due to staff shortages at weekends. "Our findings should be an incentive to strengthen the resources for this interdisciplinary care," says Dr. Christian Puelacher, lead author of the study. The research underpins the current guidelines of the European Society of Cardiology and opens up new perspectives: artificial intelligence could help to identify high-risk patients at an early stage and teleconsultations could improve care in smaller hospitals. This study has just been published in the European Heart Journal.