Physician management of asymptomatic myocardial injury after non-cardiac surgery showed high consensus for initiating ASA (91%) and statins (90%), but varied opinions regarding cardiac imaging.
Cross-Sectional (n=103)
How do physicians manage patients with myocardial injury after non-cardiac surgery (MINS)?
Physicians generally agree on prescribing ASA and statins for MINS and arranging specialist follow-up, but there is significant variation in the use of cardiac imaging.
Objective: To describe how physicians manage patients with myocardial injury (i.e., a troponin elevation of presumed ischemic origin) after non-cardiac surgery (MINS). Methods: Web-based survey to physicians distributed between December 2020 and September 2021, including a case scenario of asymptomatic MINS. Results: Of 103 respondents, 94% were practicing in Canada and 65% were general internists. 97% of respondents would order an ECG; following a normal ECG, 46% of would order an echocardiogram; following a normal echocardiogram, 42% would order myocardial perfusion imaging. Of the respondents, 91% and 90% would initiate ASA and a statin, respectively; 24%, 21%, and 7% would initiate an ACE inhibitor, a beta-blocker, and dabigatran, respectively. Most participants indicated that outpatient follow-up with a medicine specialist within 1–2 months (90%) and 1 year (68%) was appropriate. Conclusion: Respondents generally agreed that ASA and statins should be prescribed for MINS, and that post-discharge specialist follow-up is warranted. However, opinions regarding the role of cardiac imaging varied.
Selznick et al. (Wed,) conducted a cross-sectional in Myocardial injury after non-cardiac surgery (MINS) (n=103). Physician management of asymptomatic myocardial injury after non-cardiac surgery showed high consensus for initiating ASA (91%) and statins (90%), but varied opinions regarding cardiac imaging.