ArticleNetherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation2013
The aetiology of myocardial injury after non-cardiac surgery.
Article in Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Myocardial injury after major non-cardiac surgery evaluated with advanced cardiac imaging: a pilot study.BMC cardiovascular disorders · 2023Article
- Natriuretic Peptides and Troponins to Predict Cardiovascular Events in Patients Undergoing Major Non-Cardiac Surgery.International journal of environmental research and public health · 2022Review
- Association between tissue oxygenation and myocardial injury in patients undergoing major spine surgery: a prospective cohort study.BMJ open · 2021Observational
- Myocardial injury in non-cardiac surgery: complexities and challenges.Singapore medical journal · 2020Article
- Causes and prevention of postoperative myocardial injury.European journal of preventive cardiology · 2019Review
- [Perioperative risk and mortality after major surgery].Der Anaesthesist · 2015Review
- From theory to the bedside of the patient: it's a long and devious way to go.Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation · 2013Article
Corrections and comments
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Authors and funding
4 authors.
Funding
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Abstract
Recognition of myocardial injury after non-cardiac surgery is difficult, since strong analgesics (e.g. opioids) can mask anginal symptoms, and ECG abnormalities are subtle or transient. Thorough knowledge of the pathophysiological mechanisms is therefore essential. These mechanisms can be subdivided into four groups: type I myocardial infraction (MI), type II MI, non-ischaemic cardiac pathology, and non-cardiac pathology. The incidence of type I MI in patients with a clinical suspicion of perioperative acute coronary syndrome (ACS) is 45-57 %. This percentage is higher in patients with a high likelihood of MI such as patients with ST-elevation ACS. Of note, the generalisability of this statement is limited due to significant study limitations. Non-ischaemic cardiac pathology and non-cardiac pathology should not be overlooked as a cause of perioperative myocardial injury (PMI). Especially pulmonary embolism and dysrhythmias are a common phenomenon, and may convey important prognostic value. Implementation of routine postoperative troponin assessment and accessible use of minimally invasive imaging should be considered to provide adequate individualised therapy. Also, addition of preoperative imaging may improve the stratification of high-risk patients who may benefit from preoperative or perioperative interventions.
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Registered trials
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