Key result
Patients aged under 45 years had a significantly lower incidence of myocardial injury after non-cardiac surgery compared to older patients (11.7% vs. 16.6%; OR 0.77), though MINS remained strongly associated with 30-day mortality regardless of age.
Why the study?
The study sought to compare myocardial injury after non-cardiac surgery (MINS) and mortalities between patients under and over the age of 45 years.
Does myocardial injury after non-cardiac surgery (MINS) have a similar prognostic impact on 30-day mortality in patients aged <45 years compared to those ≥45 years?
Cohort (n=35,223)
No
Does myocardial injury after non-cardiac surgery (MINS) have a similar prognostic impact on 30-day mortality in patients aged <45 years compared to those ≥45 years?
Odds Ratio: 0.77 (95% CI 0.69–0.84)
Absolute Event Rate: 11.7% vs 16.6%
p-value: p=<0.001
Although younger patients (<45 years) have a lower overall incidence of myocardial injury after non-cardiac surgery, the occurrence of MINS carries a similarly high risk for 30-day mortality as it does in older patients.
BACKGROUND: This study compared myocardial injury after non-cardiac surgery (MINS) and mortalities between patients under and over the age of 45 years. METHODS AND RESULTS: From January 2010 and June 2019, patients with cardiac troponin measurement within 30 days after non-cardiac surgery were enrolled and divided into groups according to age: >45 (≥45 years) and <45 (<45 years). Further analyses were conducted only in patients who were diagnosed with MINS. The outcomes were MINS and 30-day mortality. Of the 35,223 patients, 31,161 (88.5%) patients were in the >45-year group and 4,062 (11.5%) were in the <45-year group. After adjustment with inverse probability of weighting, the <45-years group showed a lower incidence of MINS and cardiovascular mortality (16.6% vs. 11.7%; odds ratio, 0.77; 95% confidence interval [CI], 0.69-0.84; P<0.001 and 0.4% vs. 0.2%; hazard ratio [HR], 0.41; 95% CI, 0.19-0.88; P=0.02, respectively). In a comparison of only the <45-years group, MINS was associated with increased 30-day mortality (0.7% vs. 10.3%; HR, 10.48; 95% CI, 6.18-17.78; P<0.001), but the mortalities of patients with MINS did not differ according to age. CONCLUSIONS: MINS has a comparable prognostic impact in patients aged under and over 45 years; therefore, future studies need to also consider patients aged <45 years regarding risk factors of MINS and screening of perioperative troponin elevation.
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Park et al. (2021) conducted a cohort in Myocardial injury after non-cardiac surgery (MINS) (n=35,223). Age <45 years vs. Age ≥45 years was evaluated on Myocardial injury after non-cardiac surgery (MINS) (OR 0.77, 95% CI 0.69-0.84, p=<0.001). Patients aged under 45 years had a significantly lower incidence of myocardial injury after non-cardiac surgery compared to older patients (11.7% vs. 16.6%; OR 0.77), though MINS remained strongly associated with 30-day mortality regardless of age.
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