Wednesday, 26 March 2014

Myocardial Injury after Noncardiac Surgery. A Large, International, Prospective Cohort Study Establishing Diagnostic Criteria, Characteristics, Predictors, and 30-day Outcomes. Anesthesiology, V 120 • No 3. March 2014

This large study showed that myocardial injury after non-cardiac surgery is an independent predictor of 30-day mortality. Myocardial injury (diagnosed by a troponin T peak of 0.03 ng/ml) is relatively common (8% of patients) and mainly occurs in the first 2 days after surgery. 1 in 10 of these patients will die in the next 30 days. This can be easily missed since most patients do not have any ischemic symptoms and do not fit the diagnostic criteria for myocardial infarction. Patients who had a troponin rise from nonischemic etiology such as pulmonary embolism or sepsis were excluded. It is estimated that worldwide around 8 million patients per year may suffer from perioperative myocardial injury.

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