Myocardial injury after noncardiac surgery occurs in approximately 20% of patients undergoing major inpatient surgery and is strongly associated with short-term and long-term mortality.
This AHA scientific statement provides diagnostic criteria, epidemiology, prognosis, surveillance strategies, and treatment approaches for myocardial injury after noncardiac surgery.
Myocardial injury after noncardiac surgery is defined by elevated postoperative cardiac troponin concentrations that exceed the 99th percentile of the upper reference limit of the assay and are attributable to a presumed ischemic mechanism, with or without concomitant symptoms or signs. Myocardial injury after noncardiac surgery occurs in ≈20% of patients who have major inpatient surgery, and most are asymptomatic. Myocardial injury after noncardiac surgery is independently and strongly associated with both short-term and long-term mortality, even in the absence of clinical symptoms, electrocardiographic changes, or imaging evidence of myocardial ischemia consistent with myocardial infarction. Consequently, surveillance of myocardial injury after noncardiac surgery is warranted in patients at high risk for perioperative cardiovascular complications. This scientific statement provides diagnostic criteria and reviews the epidemiology, pathophysiology, and prognosis of myocardial injury after noncardiac surgery. This scientific statement also presents surveillance strategies and treatment approaches.
A 2021 study conducted a review in Myocardial injury after noncardiac surgery. Myocardial injury after noncardiac surgery occurs in approximately 20% of patients undergoing major inpatient surgery and is strongly associated with short-term and long-term mortality.