El reemplazo de Articulaciones es bueno para su corazón / Joint Replacement Is Good for Your Heart

Este artículo es originalmente publicado en:
Ravi B1, Croxford R, Austin PC, Lipscombe L, Bierman AS, Harvey PJ, Hawker GA.
BMJ. 2013 Oct 30;347:f6187. doi: 10.1136/bmj.f6187.
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This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/.

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


Relación entre la artroplastia total de la articulación y el riesgo de eventos cardiovasculares graves en pacientes con osteoartritis moderada-grave: puntuación de la propensión igualados al análisis histórico.


To examine whether total joint arthroplasty of the hip and knee reduces the risk for serious cardiovascular events in patients with moderate-severe osteoarthritis.
Propensity score matched landmark analysis.

Ontario, Canada.

2200 adults with hip or knee osteoarthritis aged 55 or more at recruitment (1996-98) and followed prospectively until death or 2011.

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.

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<0.001). Within seven years of the exposure period the absolute risk reduction was 12.4% (95% confidence interval 1.7% to 23.1%) and number needed to treat was 8 (95% confidence interval 4 to 57 patients).

Using a propensity matched landmark analysis in a population cohort with advanced hip or knee osteoarthritis, this study found a cardioprotective benefit of primary elective total joint arthroplasty.



Para examinar si la artroplastia total de la articulación de la cadera y la rodilla reduce el riesgo de eventos cardiovasculares graves en pacientes con osteoartritis moderada-severa.


 El resultado de propensión se igualó al análisis histórico.


 Ontario, Canadá.


 2.200 adultos con osteoartritis de rodilla o de cadera 55 o más años de edad al momento del reclutamiento (1996-1998) y seguidos prospectivamente hasta la muerte o 2011.

Medida de resultado principal:

 Las tasas de eventos cardiovasculares graves para los que recibieron una artroplastia total primaria en comparación con los que lo hicieron no dentro de un período de exposición de tres años después de la evaluación inicial.


 El puntaje de propensión coincidente cohorte constaba de 153 parejas de participantes con artritis moderada-severa. Durante un período de seguimiento medio de los siete años siguientes a la fecha de la marca (inicio del estudio), los participantes emparejados que se sometieron a una artroplastia total durante el período de exposición fueron significativamente menos propensos que los que no lo hicieron a experimentar un evento cardiovascular (cociente de riesgos 0,56, 95% intervalo de confianza 0,43 a 0,74; p <0,001). Dentro de los siete años del período de exposición la reducción del riesgo absoluto fue del 12,4% (95% intervalo de confianza del 1,7% al 23,1%) y el número necesario a tratar fue de 8 (95% intervalo de confianza 4-57 pacientes).


 Utilizando un análisis histórico de propensión emparejado en una cohorte de población con osteoartritis avanzada de cadera o rodilla, este estudio encontró un beneficio cardioprotector de la artroplastia total primaria electiva.

Comment in
Can joint replacement reduce cardiovascular risk? [BMJ. 2013]

Republished in
The relation between total joint arthroplasty and risk for serious cardiovascular events in patients with moderate-severe osteoarthritis: propensity score matched landmark analysis. [Br J Sports Med. 2014]
PMID: 24174640 [PubMed – indexed for MEDLINE]
PMCID: PMC3813386
Free PMC Article

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