The risk of cardiovascular disease increases in osteoarthritis patients eligible for joint replacement surgery: a mendelian randomization study

In clinical practice, it has been observed that patients undergoing joint replacement surgery during the perioperative period have a higher probability of developing cardiovascular diseases (CVD). Additionally, the overall health status of patients varies depending on whether they require joint replacement. This study uses Mendelian randomization to analyze whether there is an increased risk of cardiovascular disease in osteoarthritis (OA) patients eligible for joint replacement surgery and those not eligible, compared to non-OA patients. Mendelian randomization was conducted using downloaded genome-wide association study (GWAS) data on OA and CVD. The OA data was categorized into four groups: knee OA with joint replacement, knee OA without joint replacement, hip OA with joint replacement, and hip OA without joint replacement. CVD considered included coronary artery disease, heart failure, atrial fibrillation, ischemic stroke, and venous thromboembolism. Causal inference analyses were performed using inverse variance weighted (IVW), weighted median, and MR-Egger methods. Finally, MR-Egger, MR-Presso, and Cochran’s Q statistical methods were used to evaluate heterogeneity and pleiotropy. The IVW analysis revealed that individuals who underwent knee joint replacement had an increased risk of coronary artery disease (OR: 1.06, 95% CI: 1.01–1.12, P = 0.020), ischemic stroke (OR: 1.09, 95% CI: 1.02–1.16, P = 0.013), and venous thromboembolism (OR: 1.21, 95% CI: 1.11–1.33, P < 0.001). Similarly, individuals who underwent hip joint replacement had an increased risk of coronary artery disease (OR: 1.06, 95% CI: 1.02–1.10, P = 0.001) and ischemic stroke (OR: 1.06, 95% CI: 1.02–1.10, P = 0.007). In contrast, patients who did not undergo joint replacement did not show an elevated risk of CVD. Our study supports an increased risk of certain CVD among patients undergoing joint replacement surgery. For these patients, clinical practitioners need to pay particular attention to their cardiovascular health status. Not applicable.