Association of appendectomy with decreased risk of cardiovascular events in elderly Australian patients

BackgroundThe appendix is thought to contribute to gut and systemic immune system function, and thus could influence cardiovascular health and disease progression. However, it is unclear if there is an association between appendectomy and cardiovascular risk. This study aimed to estimate the strength of any such association in 978,095 Australian hospital patients aged [&ge;]60 years, among which 5,130 underwent appendectomy. MethodsThe association of appendectomy with cardiovascular events (myocardial infarction, angina, stroke and transient ischemic attack) was analysed using binary logistic regression adjusting for age, sex, cardiovascular risk factors, and gastrointestinal disorders. ResultsAppendectomy was inversely associated with overall cardiovascular risk (odds ratio [OR], 0.73; 95% confidence interval [CI], 0.66-0.81; P<0.001), myocardial infarction (OR, 0.71; 95% CI, 0.63-0.80; P<0.001) and stroke (OR, 0.77; 95% CI, 0.66-0.90; P=0.001) after adjustment for all the test confounders. This inverse association existed in both sexes and remained when hernia surgery was used as a control instead of patients without appendectomy. ConclusionsThis study found that appendectomy was associated with >27% lower multivariate-adjusted risk for overall cardiovascular events, myocardial infarction, or stroke, in patients aged 60 years and over. Our results provide additional support for the current clinical practice of removing the appendix in the elderly when appendicitis is suspected.