Abstract

Clinical approach to myocardial injury after non-cardiac surgery

Author(s): Besher Kashlan, Mushabbar Syed

Myocardial Injury after Noncardiac Surgery (MINS) is the most frequent cardiovascular complication following noncardiac surgery and independently poses a significant risk of perioperative morbidity and mortality. MINS can be with or without myocardial infarction and is often driven by intraoperative factors such as hypotension, tachycardia, and anemia. Prevention of MINS centers on a thorough preoperative risk assessment and personalized risk-factor modification, including the individualized use of betablockers, antiplatelet agents, statins, and ACE inhibitors/ARB. Routine postoperative troponin surveillance for high-risk individuals can facilitate early detection, closer monitoring, and timely intervention. Despite an absence of consensus on a standardized treatment approach, recent evidence suggests that interventions, such as early cardiology consultation and judicious use of moderate-intensity anticoagulation, could improve outcomes. This brief review aims to enhance understanding of MINS and offer a potential framework for approaching these patients.