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Myocardial injury in non-cardiac surgery: complexities and challenges
1Department of Internal Medicine, Woodlands Health Campus, Singapore.
Singapore Medical Journal
|February 12, 2020
Summary
Myocardial injury after non-cardiac surgery (MINS) is perioperative troponin elevation linked to higher mortality. Improved awareness and monitoring of MINS are crucial for better surgical patient outcomes.
Area of Science:
- Cardiology
- Anesthesiology
- Perioperative Medicine
Background:
- Myocardial injury after non-cardiac surgery (MINS) describes perioperative troponin elevation from cardiac causes.
- The term is often applied to cases not meeting myocardial infarction criteria, including asymptomatic troponin elevation.
- This perioperative troponin elevation is associated with increased mortality.
Purpose of the Study:
- To highlight the significance of MINS in surgical patients.
- To emphasize the need for increased awareness and improved implementation of perioperative troponin monitoring.
- To underscore the importance of MINS detection, management, and prevention.
Main Methods:
- Literature review and synthesis of current understanding regarding MINS.
- Analysis of the implications of MINS on surgical patient outcomes.
- Assessment of current awareness and monitoring practices for MINS.
Main Results:
- MINS is frequently used to describe perioperative troponin elevation not meeting myocardial infarction criteria.
- Asymptomatic MINS is linked to elevated mortality in surgical patients.
- Awareness and implementation of perioperative troponin monitoring for MINS remain low.
Conclusions:
- MINS represents a significant risk factor in non-cardiac surgery.
- Enhanced practitioner awareness and consistent perioperative troponin monitoring are essential.
- Addressing MINS is vital for improving surgical patient outcomes.
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