Surgery Tag

Old Age No Bar to Successful Heart Transplant, Study Finds

FRIDAY, June 11, 2021 (HealthDay News) — People over 70 are far less likely to be considered for or to receive a new heart — even though new research suggests their survival rates after transplant are similar to those of younger patients.

For the study, the researchers analyzed data on more than 57,000 adults (aged 18 and older) listed as heart transplant surgery candidates in the United States between January 2000 and August 2018, and they found that only one in 50 was aged 70 or older.

The rate was the same among the more than 37,000 patients who actually had a heart transplant during the study period. However, the researchers did find that the number of older patients receiving a heart transplant each year rose from 30 in 2000 to 132 in 2017.

There was no significant difference between age groups in death rates in the first year after heart transplant, even though older patients were more likely to receive hearts from older donors with chronic diseases, like diabetes and high blood pressure.

The difference in death rates between older and younger patients within five years after heart transplant disappeared when the researchers accounted for factors like patients’ body mass index (or BMI, which is an estimate of body fat based on weight and height) and the time patients spent on the transplant waiting list.

Older patients were more likely to have a stroke after a heart transplant, but the risk was still very low (3.5%). Most strokes in older patients occurred in the third year after their transplant, according to study author Dr. Abhishek Jaiswal, of the Hartford Hospital in Connecticut, and colleagues.

The study, published online June 8 in the Journal of the American Geriatrics Society, shows that older age alone should not prevent people from being considered for heart transplants, the researchers said.

In addition, people 70 and older with heart failure should consider asking their cardiologist if they could be a candidate for a heart transplant, the study authors suggested in a journal news release.

The researchers noted that most of the older patients in the study who received heart transplants were white, not frail, and didn’t have other chronic diseases, and that this group of patients doesn’t represent most older adults who have heart failure.

More information

The U.S. National Heart, Lung, and Blood Institute has more on heart transplantation.

SOURCE: Journal of the American Geriatrics Society, news release, June 9, 2021

Smokers, Obese People Need Major Heart Interventions Earlier in Life

FRIDAY, June 11, 2021 (HealthDay News) — In a finding that confirms healthy habits make for healthy hearts, new research shows that smokers and obese people must have their clogged arteries cleared at much younger ages than nonsmokers or people who are a normal weight.

It found that angioplasty and/or stenting to widen coronary arteries and restore blood flow had to be performed in smokers nearly a decade sooner than in nonsmokers, and that obese patients who had these procedures were four years younger than patients who weren’t obese.

Women also typically had their first procedure to clear blocked arteries at a later age than men, according to the researchers.

The study included more than 108,000 patients without a history of heart attack who were treated at hospitals across Michigan participating in the Blue Cross Blue Shield of Michigan Cardiovascular Consortium.

Nearly all of the patients had at least one risk factor for heart trouble — including smoking, obesity, high blood pressure, high cholesterol and diabetes — and most of them had three or more risk factors.

Over the past decade, rates of obesity and diabetes have increased among patients undergoing their first angioplasty or stent procedure, while rates of smoking and high cholesterol have decreased, according to the researchers.

“Smoking is a completely preventable risk factor,” said senior study author Dr. Devraj Sukul, an interventional cardiologist and a clinical lecturer at the University of Michigan Health Frankel Cardiovascular Center.

“If we direct additional efforts at preventing smoking and obesity, we could significantly delay the onset of heart disease and the need for angioplasty and stenting,” Sukul said in a university news release.

“In Michigan, we will work to help every smoker quit at the time of cardiac care because it is an unmatched teachable moment for patients,” said Dr. Michael Englesbe, a surgeon and professor at Michigan Medicine.

The findings were published June 9 in the journal PLOS ONE.

More information

The U.S. National Library of Medicine has more on angioplasty and stent placement.

SOURCE: Michigan Medicine-University of Michigan, news release, June 9, 2021