Newbriefs: Shoulder Replacements; Pneumonia Shots; Flu & Acute Cardiovascular Events; Bone Drugs & Atypical Fractures
Most Shoulder Replacements Last More Than 10 Years
The vast majority of shoulder replacement implants last more than 10 years, according to a large UK study published in the September issue of The Lancet Rheumatology. For the study, researchers examined data on nearly 18,000 people who underwent total, partial, or reverse shoulder replacement. The analysis showed that more than 90 percent of the replacement joints were still working well a decade or longer after the surgery, and most shoulder replacement recipients continued to report that they felt the procedure had benefited them. See our November issue for more information on what’s involved in shoulder replacement surgery.
Flu, Pneumonia Shots Vital in Heart Failure
Influenza and pneumonia vaccinations are associated with fewer hospital deaths in people with heart failure, according to a study presented at the European Society of Cardiology Congress 2020, Aug. 28. In heart failure, the heart is unable to pump blood around the body as well as it should. This can lead to a build-up of fluid in the lungs that causes shortness of breath and often leads to hospitalization. Respiratory infections such as influenza and pneumonia make heart failure worse, and annual vaccinations are recommended. The study included more than 2.9 million people, average age 70, who were admitted to the hospital due to heart failure. Just 1.4 percent had received the flu vaccine and 1.4 percent had the pneumonia vaccine. The analysis showed that the rate of in-hospital mortality was 1.3 percent in people who had been vaccinated against the flu compared to 3.6 percent in those who did not receive the flu vaccine. Rates of in-hospital mortality also were lower in people vaccinated against pneumonia compared to those who were not (1.2 percent vs. 3.6 percent). Getting vaccinated against the flu and pneumonia may be even more important this year due to the covid-19 pandemic. If you have not received these vaccinations, ask your doctor about getting them, whether or not you suffer from heart failure.
Flu Linked to Acute Cardiovascular Events
About 12 percent of people who are hospitalized for the flu have an acute cardiovascular event, according to a recent study (Annals of Internal Medicine, Aug. 25). The study included data on about 80,000 people who were hospitalized for the flu during the 2010-2011 through 2017-2018 flu seasons. Acute heart failure and acute ischemic heart disease were the most common cardiovascular events, affecting 6.2 and 5.7 percent of study participants, respectively. Older age was significantly associated with greater risk, along with tobacco use, underlying cardiovascular disease, diabetes, and kidney disease. The data provide more evidence that increasing rates of influenza vaccination, particularly among older adults and people with cardiovascular risk factors, is vital for preventing infection and flu-related complications.
Bone Drugs and Atypical Fractures
It is well known that bisphosphonate drugs prevent hip fractures if you have the bone-thinning disease osteoporosis. For most people with osteoporosis, this benefit far outweighs the possible side effects of the drugs. One rare side effect is atypical fracture of the femur (AFF), and a recent study (New England Journal of Medicine, Aug. 20) suggests that longer duration of bisphosphonate use increases AFF risk. The 10-year study included nearly 200,000 women age 50 or older. Those who took bisphosphonates for three to five years had a 9 percent greater risk of AFF than women who took the drugs for less than three months. Women who took the drugs for eight years or more had a 43 percent greater risk. While these data look alarming, hip fractures are far more common than AFF; moreover, most women in the United States are advised to take a “bisphosphonate holiday” after about five years. According to the study, the risk of AFF rapidly decreased once bisphosphonates were discontinued.
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