Navigation Links
Surgical removal of the tonsils and appendix associated with risk of early heart attack
Date:5/31/2011

The surgical removal of the appendix and tonsils before the age of 20 was associated with an increased risk of premature heart attack in a large population study performed in Sweden.(1) Tonsillectomy increased the risk by 44% (hazard ratio 1.44) and appendectomy by 33% (HR 1.33). The risk increases were just statistically significant, and were even higher when the tonsils and appendix were both removed. However, there was no risk association evident when the operations were performed in people over the age of 20.

Both the appendix and tonsils are lymphoid organs and thus components of the body's immune system, albeit of modest importance. The recurrence of tonsillitis and appendicitis - caused by infection - are the usual reasons for removal. Behind the study lay evidence that removal was associated with moderate long-term effects on the immune system and alterations in risk for some autoimmune disorders. Studies suggest that between 10 and 20% of all young people have tonsils or appendix removed.

"Given the strong biological and epidemiological evidence linking inflammation with coronary heart disease," said investigator Dr Imre Janszky from the Department of Public Health Science of the Karolinska Institute in Stockholm, "one might anticipate that surgical removal of the tonsils and appendix, with their consequent effects on immunity, might also have a long-term effect on CHD. However, we were aware of no studies evaluating the potential effects of appendectomy or tonsillectomy on atherosclerosis or CHD risk."

The study, published online today in the European Heart Journal, examined the national health records of every Swedish resident born between 1955 and 1970 and identified each one who had had tonsils and/or appendix removed. Each of these "cases" was then matched with five randomly chosen "controls" who had not had the operations. These subjects were then followed up through the health records for an average of 23.5 years to cross-check for the occurrence of fatal or non-fatal heart attack (acute myocardial infarction, AMI). Because the appendix and tonsils appear to have reduced function after adolescence, the primary analyses were restricted to individuals below the age of 20 at the time of surgery, which amounted to 54,449 appendectomies and 27,284 tonsillectomies.

Results showed that these cases had a higher prevalence of AMI than the controls, with 89 of the appendectomies and 47 of the tonsillectomies experiencing an AMI within the follow-up period. When compared with controls, the added risk was calculated as a hazard ratio of 1.33 (95% confidence interval 1.05 1.70) for appendectomy and 1.44 (95% CI 1.04 2.01) for tonsillectomy.

Dr Janszky, the study's first author, emphasises that the absolute numbers of AMI cases in the study are small, with only slightly more than 400 and 200 total cases of AMI in more than 7.5 million and nearly 4 million person-years of follow-up. "As expected from the young age of the population," he says, "the observed moderate increases in relative risk actually corresponded to very small risk increases in absolute terms." The investigators also note that the study population, despite its size, was restricted to childhood exposure, with participants still relatively young at the end of follow-up. "Consequently," they write, "we cannot directly extrapolate our findings to cases of AMI that occur among older men or women, in whom risk is highest."

In explaining the results the authors also implicate some "complex" long-term effect of the immune system, noting that the appendix and tonsils are secondary lymphoid organs whose removal can affect several aspects of immune activity, including decreased production of immunoglobulins. They also note that atherosclerosis, the underlying pathophysiology of AMI, is widely considered to be an inflammatory process.

"In the light of our current knowledge on the complex relationship between atherosclerosis and the immune system, the findings are biologically plausible," said Dr Janszky. "There is already some evidence that removal of the spleen, another secondary lymphoid organ, is also associated with accelerated atherosclerosis and increased cardiovascular risk."


'/>"/>

Contact: Jacqueline Partarrieu
press@escardio.org
33-492-947-756
European Society of Cardiology
Source:Eurekalert

Related medicine news :

1. New Stanford device could reduce surgical scarring
2. 3-D printing technology from CT images may be used effectively for neurosurgical planning
3. UCI anesthesiologist to lead study on alleviating surgical anxiety, pain in children
4. Outcome of nonsurgical hepatic decompression in Budd-Chiari
5. Surgical technique helps adult male survivors of childhood cancer regain fertility
6. Surgical instruments with electronic serial numbers
7. New long-acting local anesthetic derived from algae effectively blocks pain in surgical patients
8. Study Finds Too Many Surgical Breast Biopsies Performed
9. John Theurer Cancer Center orthopedic oncologist shares new limb sparing surgical techniques
10. Will Loss of Lethal Injection Drug Harm Surgical Patients?
11. Pre-surgical stress management boosts immune function, lowers mood disturbance in prostate cancer patients
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:2/24/2017)... ... February 24, 2017 , ... With millions of Americans ... important that we all are aware of our options and are empowered with ... announce the launch of its newest edition of "Vision and Hearing" in USA ...
(Date:2/24/2017)... Viejo, CA (PRWEB) , ... February 24, 2017 , ... ... Final Cut Pro X . Users have total control over position, rotation, distortion, ... and more all within Final Cut Pro X. , With ProGlass Prism users are ...
(Date:2/24/2017)... ... February 24, 2017 , ... The International Association of Eating Disorders Professionals (iaedp) ... You See” body image mannequin art competition. Selected from 15 submissions from around the ... revealed at the 31st annual iaedp Symposium, March 22 – 26 in Las Vegas. ...
(Date:2/24/2017)... , ... February 24, 2017 , ... ... services, which specializes in thought leadership , media relations, social media, content ... services that will be powered through Act-On, an intuitive marketing automation platform. , ...
(Date:2/23/2017)... ... February 23, 2017 , ... Thinksport, the most ... Jensie Gran Fondo of Marin. For the second year in a row, cyclists ... sunscreen. , “We are thrilled to provide our safe, non-toxic sunscreen to over ...
Breaking Medicine News(10 mins):
(Date:2/24/2017)... 23, 2017  The particle counters market is ... from USD 275.9 million in 2016, at a ... report: http://www.reportlinker.com/p04718602-summary/view-report.html The growing ... R&D, and growth in manufacturing industries in emerging ... for particle counters. On the other hand, technical ...
(Date:2/24/2017)... Feb. 24, 2017  Xynomic Pharmaceuticals, Inc., an oncology ... it has acquired exclusive worldwide rights to develop, ... HDAC inhibitor targeting hematological and solid tumors. ... 1 and 2 clinical trials of Abexinostat in ... have already been completed, demonstrating that Abexinostat is ...
(Date:2/23/2017)... , Feb. 23, 2017 Visiomed, ... and services since 1997, is changing the landscape ... technology providing patients with pro-active, custom-made solutions. Recognizing ... for instant and affordable healthcare without walls, Visiomed ... high-level devices developed with healthcare professionals that is ...
Breaking Medicine Technology: