Myocardial injury after non-cardiac surgery: current state of the problem and unresolved issues

The survey based on the last decade literature, guidelines of international and national professional communities summarizes data on myocardial injury after non-cardiac surgery (MINS). It reflects the growing interest in this interdisciplinary problem aroused by MINS widespread occurrence and its close association with after surgery mortality. Observational studies devoted to a search for risk factors and mechanisms of after surgery myocardial injury were scrutinized. The role of asymptomatic increase in cardiac troponins which is stiffly competitive in its clinical and prognostic significance with after surgery myocardial infarction was highlighted. Modern approaches to MINS diagnostics and prevention were set out. The possibilities and prospects for MINS treatment were discussed with regard for the results of the recently completed randomized controlled study MANAGE (2018). Unresolved issues and avenues of further investigations in the field were specified.