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Myocardial Injury After Lung Cancer Surgery: Incidence, Characteristics, Risk Factors, and Prognosis: A Retrospective
Zhan Liu1, Chengwei Zhao2, Weipeng Shao2
1Department of Lung Surgical, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China. byliuzhan@126.com.
Myocardial injury after non-cardiac surgery (MINS) affects over 10% of lung cancer patients undergoing surgery, often presenting asymptomatically early post-op. While not increasing 30-day mortality, MINS significantly elevates the risk of major adverse cardiovascular events (MACE).
Area of Science:
- Cardiology
- Thoracic Surgery
- Oncology
Background:
- Myocardial injury after non-cardiac surgery (MINS) is a recognized complication.
- Lung cancer surgery, particularly pulmonary resection, carries inherent cardiovascular risks.
- Understanding MINS in this specific patient population is crucial for risk stratification and management.
Purpose of the Study:
- To determine the incidence and characteristics of MINS in lung cancer patients undergoing pulmonary resection.
- To identify preoperative risk factors associated with MINS.
- To evaluate the prognostic implications of MINS, including 30-day mortality and major adverse cardiovascular events (MACE).
Main Methods:
- Retrospective analysis of 1314 lung cancer patients undergoing elective pulmonary resection.
- Univariate and multivariate logistic regression for risk factor identification.
- Kaplan-Meier survival analysis and log-rank tests for MACE and mortality assessment.
Main Results:
- The incidence of MINS was 10.4%, predominantly occurring within the first postoperative day and often asymptomatic.
- Independent risk factors included male sex, coronary artery disease, elevated creatinine and troponin T, thoracotomy, lobectomy, and tachycardia duration.
- MINS was not associated with 30-day mortality but significantly increased 30-day MACE risk across all surgical extents.
Conclusions:
- MINS is a frequent early postoperative complication in lung cancer surgery patients.
- Despite being often asymptomatic, MINS is a significant predictor of short-term MACE.
- Early identification and management of MINS risk factors are essential in this cohort.
