What is the patient's risk for perioperative cardiac complications and should they hold aspirin (acetylsalicylic acid) 5-7 days before a right total knee arthroplasty (RTKA) given their history of coronary artery disease (CAD), congestive heart failure (CHF), hypertension (HTN), hyperlipidemia (HLD), and obstructive sleep apnea (OSA)?

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Perioperative Cardiac Risk Assessment and Aspirin Management for Right Total Knee Arthroplasty

This patient has an intermediate perioperative cardiac risk (approximately 1-5%) for major adverse cardiovascular events, and aspirin should be CONTINUED perioperatively rather than held for 5-7 days. 1

Cardiac Risk Stratification

Risk Assessment:

  • Total knee arthroplasty is classified as low-to-intermediate risk surgery with a 30-day cardiac event rate of <1% 1
  • This patient has multiple cardiac risk factors including:
    • Non-obstructive CAD (documented on catheterization) 1
    • CHF with reduced EF (45-50%, down from normal) 1
    • Hypertension 1
    • Obstructive sleep apnea 2

Functional Capacity Consideration:

  • The patient's functional capacity is not explicitly stated, but the presence of CHF with mildly reduced EF suggests likely <4 METs 1
  • With poor functional capacity (<4 METs) and multiple cardiac risk factors, this places the patient at intermediate perioperative cardiac risk 1

Overall Risk Estimate:

  • Based on the Revised Cardiac Risk Index criteria (CAD, CHF), this patient has ≥2 risk factors, predicting a perioperative major adverse cardiovascular event risk of approximately 1-5% 2
  • The combination of documented CAD (even if non-obstructive) and systolic dysfunction (EF 45-50%) elevates risk above the baseline for orthopedic surgery 1

Aspirin Management Decision

ASPIRIN SHOULD BE CONTINUED:

The 2024 ACC/AHA guidelines explicitly state that in patients with CAD undergoing noncardiac surgery, it is recommended to continue aspirin (75-100 mg) if possible to reduce the risk of cardiac events. 1

Key Evidence Supporting Continuation:

  • For patients with established CAD (even non-obstructive), continuation of aspirin reduces perioperative thrombotic complications more than it increases bleeding risk in orthopedic surgery 1
  • The 2014 ESC/ESA guidelines state that "continuation or discontinuation of aspirin should be based on an individual decision that depends on the perioperative bleeding risk weighed against the risk of thrombotic complications" 1
  • Total knee arthroplasty has acceptable surgical bleeding risk that does not mandate aspirin discontinuation in patients with CAD 1

Evidence Against Routine Discontinuation:

  • Routine perioperative discontinuation of aspirin in patients with CAD increases risk of myocardial infarction and stent thrombosis (if stents present) 1
  • The 2024 guidelines specifically recommend against routine initiation of aspirin in patients without prior CAD, but this patient HAS documented CAD, making continuation appropriate 1

Common Pitfalls to Avoid

Critical Errors:

  • Do NOT hold aspirin for 5-7 days in this patient with documented CAD—this significantly increases thrombotic risk without proportionate bleeding benefit in TKA 1
  • Do NOT assume all orthopedic surgery requires aspirin discontinuation—the risk-benefit calculation favors continuation in patients with established CAD 1
  • Do NOT discontinue aspirin without explicit discussion with the surgical team about bleeding risk versus thrombotic risk 1

Additional Perioperative Considerations:

  • Continue beta-blockers if the patient is already taking them (not specified in this case, but critical if present) to avoid rebound tachycardia and hypertension 1
  • Continue statins perioperatively, as they reduce postoperative cardiovascular complications (1.8% vs 2.3% mortality without statins) 2
  • ACE inhibitors/ARBs should be held on the day of surgery to reduce intraoperative hypotension risk, then resumed postoperatively 3
  • Ensure adequate perioperative monitoring given the patient's CHF with reduced EF and OSA 2, 4

Specific Recommendations

Aspirin Dosing:

  • Continue aspirin 75-100 mg daily through the perioperative period 1
  • Resume immediately postoperatively if held for any reason 1

Surgical Coordination:

  • Confirm with orthopedic surgeon that bleeding risk is acceptable with continued aspirin (it should be for routine TKA) 1
  • Consider enhanced hemostatic techniques intraoperatively (tranexamic acid, meticulous surgical technique) if bleeding concerns exist 1

Postoperative Management:

  • Monitor for both bleeding and thrombotic complications in the first 48-72 hours 2
  • Ensure DVT prophylaxis is appropriately coordinated with continued aspirin 1
  • Resume CPAP immediately postoperatively given OSA diagnosis 2

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Guideline

Perioperative Management of Antihypertensive Medications

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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