Perioperative myocardial injury common after noncardiac surgery

Editor's Note

Perioperative myocardial injury (PMI) is a common complication after noncardiac surgery (occurring in 1 of 7 patients), and it is associated with substantial short- and long-term mortality (9% and 22%), this study finds.

This analysis included 2,018 patients having 2,546 surgical procedures. PMI occurred after 397 of the surgical procedures.

Only 6% of patients (24 of 397) with PMI had typical chest pain, and 18% (72 of 397) had ischemic symptoms, which indicates a major difference from spontaneous myocardial infarction.

The major differences between PMI and spontaneous myocardial infarction mandate individualized treatment strategies, the authors note.

Background -Perioperative myocardial injury (PMI) seems to be a contributor to mortality after noncardiac surgery. Because the vast majority of PMIs are asymptomatic, PMI usually is missed in the absence of systematic screening. Methods -We performed a prospective diagnostic study enrolling consecutive patients undergoing noncardiac surgery who had a planned postoperative stay of ≥24 hours and were considered at increased cardiovascular risk.

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