ArticleBJA open2026
Aetiology and associated outcomes of myocardial injury as defined by postoperative troponin elevation in high-risk patients after noncardiac surgery: a single-centre retrospective cohort study.
Article in BJA open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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6 authors.
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Abstract
Background: Myocardial injury after noncardiac surgery is common, is frequently clinically silent, and arises from heterogeneous mechanisms. Whether structured aetiological assessment using an existing hierarchical framework is applicable in high-risk patients remains uncertain. The primary aim of this study was to determine the aetiological distribution of myocardial injury in a selectively tested high-risk cohort. Methods: This single-centre retrospective cohort study included adults undergoing noncardiac surgery during the years 2017 to 2022. Myocardial injury is defined as a high-sensitivity cardiac troponin T concentration >50 ng L Results: Of 6263 patients sampled, 1114 (18%) were diagnosed as having myocardial injury and 954 were analysed. Myocardial injury was classified as extra-cardiac in 544 (57%) and cardiac in 410 patients (43%). Renal failure was the most common extra-cardiac cause (37%) and type 2 myocardial injury the most common cardiac cause (81%). Patients with extra-cardiac injury more often underwent non-elective surgery (78% Conclusions: In this single-centre high-risk noncardiac surgical cohort, pragmatic aetiological assessment attributed myocardial injury more often to extra-cardiac mechanisms, which were associated with higher in-hospital mortality. Limited by selective postoperative troponin sampling, these findings warrant future research into the prognostic value of troponin elevations across differing aetiologies.
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