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Myocardial Injury after Noncardiac Surgery: A Large, International, Prospective Cohort Study Establishing Diagnostic Criteria, Characteristics, Predictors, and 30-day Outcomes

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dc.contributor.author Botto, F.
dc.contributor.author Alonso-Coello, P.
dc.contributor.author Chan, M.T.V.
dc.contributor.author Villar, J.C.
dc.contributor.author Xavier, D.
dc.contributor.author Srinathan, S.K.
dc.contributor.author Guyatt, G.
dc.contributor.author Cruz, P.
dc.contributor.author Graham, M.
dc.contributor.author Wang, C.Y.
dc.contributor.author Berwanger, O.
dc.contributor.author Pearse, R.M.
dc.contributor.author Biccard, B.M.
dc.contributor.author Abraham, V.
dc.contributor.author Málaga Rodríguez, Germán Javier
dc.contributor.author Hillis, G.S.
dc.contributor.author Rodseth, R.N.
dc.contributor.author Cook, D.
dc.contributor.author Polanczyk, C.A.
dc.contributor.author Szczeklik, W.
dc.contributor.author Sessler, D.I.
dc.contributor.author Sheth, T.
dc.contributor.author Ackland, G.L.
dc.contributor.author Leuwer, M.
dc.contributor.author Garg, A.X.
dc.contributor.author Lemanach, Y.
dc.contributor.author Pettit, S.
dc.contributor.author Heels-Ansdell, D.
dc.contributor.author Luratibuse, G.
dc.contributor.author Walsh, M.
dc.contributor.author Sapsford, R.
dc.contributor.author Schünemann, H.J.
dc.contributor.author Kurz, A.
dc.contributor.author Thomas, S.
dc.contributor.author Mrkobrada, M.
dc.contributor.author Thabane, L.
dc.contributor.author Gerstein, H.
dc.contributor.author Paniagua, P.
dc.contributor.author Nagele, P.
dc.contributor.author Raina, P.
dc.contributor.author Yusuf, S.
dc.contributor.author Devereaux, P.J.
dc.contributor.author McQueen, M.J.
dc.contributor.author Bhandari, M.
dc.contributor.author Bosch, J.
dc.contributor.author Buckley, N.
dc.contributor.author Chow, C.K.
dc.contributor.author Halliwell, R.
dc.contributor.author Li, S.
dc.contributor.author Lee, V.W.
dc.contributor.author Mooney, J.
dc.contributor.author Furtado, M.V.
dc.contributor.author Suzumura, E.
dc.contributor.author Santucci, E.
dc.contributor.author Leite, K.
dc.contributor.author Santo, J.A.D.E.
dc.contributor.author Jardim, C.A.P.
dc.contributor.author Cavalcanti, A.B.
dc.contributor.author Guimaraes, H.P.
dc.contributor.author Jacka, M.J.
dc.contributor.author McAlister, F.
dc.contributor.author McMurtry, S.
dc.contributor.author Townsend, D.
dc.contributor.author Pannu, N.
dc.contributor.author Bagshaw, S.
dc.contributor.author Bessissow, A.
dc.contributor.author Duceppe, E.
dc.contributor.author Eikelboom, J.
dc.contributor.author Ganame, J.
dc.contributor.author Hankinson, J.
dc.contributor.author Hill, S.
dc.contributor.author Jolly, S.
dc.contributor.author Lamy, A.
dc.contributor.author Ling, E.
dc.contributor.author Magloire, P.
dc.contributor.author Pare, G.
dc.contributor.author Reddy, D.
dc.contributor.author Szalay, D.
dc.contributor.author Tittley, J.
dc.contributor.author Weitz, J.
dc.contributor.author Whitlock, R.
dc.contributor.author Darvish-Kazim, S.
dc.contributor.author Debeer, J.
dc.contributor.author Kavsak, P.
dc.contributor.author Kearon, C.
dc.contributor.author Mizera, R.
dc.contributor.author O'Donnell, M.
dc.contributor.author Pinthus, J.
dc.contributor.author Ribas, S.
dc.contributor.author Simunovic, M.
dc.contributor.author Tandon, V.
dc.contributor.author Vanhelder, T.
dc.contributor.author Winemaker, M.
dc.contributor.author McDonald, S.
dc.contributor.author O'Bryne, P.
dc.contributor.author Patel, A.
dc.contributor.author Paul, J.
dc.contributor.author Punthakee, Z.
dc.contributor.author Raymer, K.
dc.contributor.author Salehian, O.
dc.contributor.author Spencer, F.
dc.contributor.author Walter, S.
dc.contributor.author Worster, A.
dc.contributor.author Adili, A.
dc.contributor.author Clase, C.
dc.contributor.author Crowther, M.
dc.contributor.author Douketis, J.
dc.contributor.author Gangji, A.
dc.contributor.author Jackson, P.
dc.contributor.author Lim, W.
dc.contributor.author Lovrics, P.
dc.contributor.author Mazzadi, S.
dc.contributor.author Orovan, W.
dc.contributor.author Rudkowski, J.
dc.contributor.author Soth, M.
dc.contributor.author Tiboni, M.
dc.contributor.author Acedillo, R.
dc.contributor.author Hildebrand, A.
dc.contributor.author Lam, N.
dc.contributor.author MacNeil, D.
dc.contributor.author Roshanov, P.S.
dc.contributor.author Ramsey, C.
dc.contributor.author John, P.S.
dc.contributor.author Thorlacius, L.
dc.contributor.author Siddiqui, F.S.
dc.contributor.author Grocott, H.P.
dc.contributor.author McKay, A.
dc.contributor.author Lee, T.W.R.
dc.contributor.author Amadeo, R.
dc.contributor.author Funk, D.
dc.contributor.author McDonald, H.
dc.contributor.author Zacharias, J.
dc.contributor.author Cortés, O.L.
dc.contributor.author Chaparro, M.S.
dc.contributor.author Vásquez, S.
dc.contributor.author Castañeda, A.
dc.contributor.author Ferreira, S.
dc.contributor.author Coriat, P.
dc.contributor.author Monneret, D.
dc.contributor.author Goarin, J.P.
dc.contributor.author Esteve, C.I.
dc.contributor.author Royer, C.
dc.contributor.author Daas, G.
dc.contributor.author Choi, G.Y.S.
dc.contributor.author Gin, T.
dc.contributor.author Lit, L.C.W.
dc.contributor.author Sigamani, A.
dc.contributor.author Faruqui, A.
dc.contributor.author Dhanpal, R.
dc.contributor.author Almeida, S.
dc.contributor.author Cherian, J.
dc.contributor.author Furruqh, S.
dc.contributor.author Afzal, L.
dc.contributor.author George, P.
dc.contributor.author Mala, S.
dc.contributor.author Muti, P.
dc.contributor.author Vizza, E.
dc.contributor.author Wang, C.Y.
dc.contributor.author Ong, G.S.Y.
dc.contributor.author Mansor, M.
dc.contributor.author Tan, A.S.B.
dc.contributor.author Shariffuddin, I.I.
dc.contributor.author Vasanthan, V.
dc.contributor.author Hashim, N.H.M.
dc.contributor.author Undok, A.W.
dc.contributor.author Ki, U.
dc.contributor.author Lai, H.Y.
dc.contributor.author Ahmad, W.A.
dc.contributor.author Razack, A.H.A.
dc.contributor.author Valderrama-Victoria, V.
dc.contributor.author Loza-Herrera, J.D.
dc.contributor.author Lazo Porras, María de los Ángeles
dc.contributor.author Rotta-Rotta, A.
dc.contributor.author Sokolowska, B.
dc.contributor.author Musial, J.
dc.contributor.author Gorka, J.
dc.contributor.author Iwaszczuk, P.
dc.contributor.author Kozka, M.
dc.contributor.author Chwala, M.
dc.contributor.author Raczek, M.
dc.contributor.author Mrowiecki, T.
dc.contributor.author Kaczmarek, B.
dc.contributor.author Cassimjee, H.
dc.contributor.author Gopalan, D.
dc.contributor.author Kisten, T.
dc.contributor.author Mugabi, A.
dc.contributor.author Naidoo, P.
dc.contributor.author Naidoo, R.
dc.contributor.author Skinner, D.
dc.contributor.author Torborg, A.
dc.contributor.author Urrutia, G.
dc.contributor.author Maestre, M.L.
dc.contributor.author Santaló, M.
dc.contributor.author Gonzalez, R.
dc.contributor.author Font, A.
dc.contributor.author Martínez, C.
dc.contributor.author Pelaez, X.
dc.contributor.author De Antonio, M.
dc.contributor.author Villamor, J.M.
dc.contributor.author García, J.A.
dc.contributor.author Ferré, M.J.
dc.contributor.author Popova, E.
dc.contributor.author Garutti, I.
dc.contributor.author Fernández, C.
dc.contributor.author Palencia, M.
dc.contributor.author Díaz, S.
dc.contributor.author Del Castillo, T.
dc.contributor.author Varela, A.
dc.contributor.author De Miguel, A.
dc.contributor.author Muñoz, M.
dc.contributor.author Piñeiro, P.
dc.contributor.author Cusati, G.
dc.contributor.author Del Barrio, M.
dc.contributor.author Membrillo, M.J.
dc.contributor.author Orozco, D.
dc.contributor.author Reyes, F.
dc.contributor.author Sapsford, R.J.
dc.contributor.author Barth, J.
dc.contributor.author Scott, J.
dc.contributor.author Hall, A.
dc.contributor.author Howell, S.
dc.contributor.author Lobley, M.
dc.contributor.author Woods, J.
dc.contributor.author Howard, S.
dc.contributor.author Fletcher, J.
dc.contributor.author Dewhirst, N.
dc.contributor.author Williams, C.
dc.contributor.author Rushton, A.
dc.contributor.author Welters, I.
dc.contributor.author Leuwer, M.
dc.contributor.author Khan, A.
dc.contributor.author Niebrzegowska, E.
dc.contributor.author Benton, S.
dc.contributor.author Wragg, A.
dc.contributor.author Archbold, A.
dc.contributor.author Smith, A.
dc.contributor.author McAlees, E.
dc.contributor.author Ramballi, C.
dc.contributor.author MacDonald, N.
dc.contributor.author Januszewska, M.
dc.contributor.author Stephens, R.
dc.contributor.author Reyes, A.
dc.contributor.author Paredes, L.G.
dc.contributor.author Sultan, P.
dc.contributor.author Cain, D.
dc.contributor.author Whittle, J.
dc.contributor.author Del Arroyo, A.G.
dc.contributor.author Sun, Z.
dc.contributor.author Finnegan, P.S.
dc.contributor.author Egan, C.
dc.contributor.author Honar, H.
dc.contributor.author Shahinyan, A.
dc.contributor.author Panjasawatwong, K.
dc.contributor.author Fu, A.Y.
dc.contributor.author Wang, S.
dc.contributor.author Reineks, E.
dc.contributor.author Blood, J.
dc.contributor.author Kalin, M.
dc.contributor.author Gibson, D.
dc.contributor.author Wildes, T.
dc.date.accessioned 2022-01-04T20:29:53Z
dc.date.available 2022-01-04T20:29:53Z
dc.date.issued 2014
dc.identifier.uri https://hdl.handle.net/20.500.12866/10369
dc.description.abstract Background: Myocardial injury after noncardiac surgery (MINS) was defined as prognostically relevant myocardial injury due to ischemia that occurs during or within 30 days after noncardiac surgery. The study’s four Objetives: were to determine the diagnostic criteria, characteristics, predictors, and 30-day outcomes of MINS. Methods: In this international, prospective cohort study of 15,065 patients aged 45 yr or older who underwent in-patient noncardiac surgery, troponin T was measured during the first 3 postoperative days. Patients with a troponin T level of 0.04 ng/ml or greater (elevated “abnormal” laboratory threshold) were assessed for ischemic features (i.e., ischemic symptoms and electrocardiography findings). Patients adjudicated as having a nonischemic troponin elevation (e.g., sepsis) were excluded. To establish diagnostic criteria for MINS, the authors used Cox regression analyses in which the dependent variable was 30-day mortality (260 deaths) and independent variables included preoperative variables, perioperative complications, and potential MINS diagnostic criteria. Results: An elevated troponin after noncardiac surgery, irrespective of the presence of an ischemic feature, independently predicted 30-day mortality. Therefore, the authors’ diagnostic criterion for MINS was a peak troponin T level of 0.03 ng/ml or greater judged due to myocardial ischemia. MINS was an independent predictor of 30-day mortality (adjusted hazard ratio, 3.87; 95% CI, 2.96–5.08) and had the highest population-attributable risk (34.0%, 95% CI, 26.6–41.5) of the perioperative complications. Twelve hundred patients (8.0%) suffered MINS, and 58.2% of these patients would not have fulfilled the universal definition of myocardial infarction. Only 15.8% of patients with MINS experienced an ischemic symptom. Conclusion: Among adults undergoing noncardiac surgery, MINS is common and associated with substantial mortality. en_US
dc.language.iso eng
dc.publisher Wolters Kluwer Health
dc.relation.ispartofseries Anesthesiology
dc.rights info:eu-repo/semantics/restrictedAccess
dc.subject human en_US
dc.subject major clinical study en_US
dc.subject outcome assessment en_US
dc.subject priority journal en_US
dc.subject clinical feature en_US
dc.subject Prospective Studies en_US
dc.subject Cohort Studies en_US
dc.subject predictive value en_US
dc.subject prognosis en_US
dc.subject mortality en_US
dc.subject Age Distribution en_US
dc.subject heart muscle injury en_US
dc.subject Myocardial Ischemia en_US
dc.subject Patient Outcome Assessment en_US
dc.subject peroperative complication en_US
dc.subject Postoperative Complications en_US
dc.subject preoperative care en_US
dc.subject Research Diagnostic Criteria en_US
dc.subject Surgical Procedures, Operative en_US
dc.subject surgical technique en_US
dc.subject troponin T en_US
dc.title Myocardial Injury after Noncardiac Surgery: A Large, International, Prospective Cohort Study Establishing Diagnostic Criteria, Characteristics, Predictors, and 30-day Outcomes en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1097/ALN.0000000000000113
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.09
dc.relation.issn 1528-1175


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