{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T15:37:22Z","timestamp":1756309042801,"version":"3.41.2"},"reference-count":12,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Roche Diagnostics International"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>This study evaluated the clinical applicability and relevance of the European Association for Cardio-thoracic Surgery (EACTS) algorithm for the diagnosis of perioperative myocardial injury and myocardial infarction (PMI) after cardiac surgery, compared to the Fourth Universal Definition of Myocardial Infarction (4UD).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>This was a prospective two-centre cohort study in adults undergoing a range of elective and urgent cardiac surgeries. PMI and myocardial injury were diagnosed using both the EACTS algorithm and the 4UD. Primary outcome was to compare PMI and myocardial injury incidences between definitions. One-year mortality hazard ratios (HRs) adjusted for EuroSCORE II were calculated for perioperative biomarker elevation, myocardial injury, and PMI versus no myocardial injury.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In total, 1142 patients were included. Most common procedures were coronary artery bypass grafting (53.0%) and isolated valve surgery (24.4%). The EACTS algorithm diagnosed 2.5% (n\u2009=\u200928) of patients as PMI (vs 2.6%, n\u2009=\u200930 with 4UD), 29.9% (n\u2009=\u2009341) as myocardial injury (vs 87.2%, n\u2009=\u2009996 with 4UD), 37.6% (n\u2009=\u2009429) as perioperative biomarker elevation, and 30.1% (n\u2009=\u2009344) as no myocardial injury (vs 10.2%, n\u2009=\u2009116 with 4UD). Adjusted HRs for 1-year mortality with the EACTS algorithm were 12.3 (95% CI, 2.0-74.7) for PMI (vs 13.7 [95% CI, 1.5-124.6] with 4UD), 3.6 (95% CI, 0.8-16.6) for myocardial injury (vs 2.3 [95% CI, 0.3-17.0] with 4UD), and 2.7 (95% CI, 0.6-12.6) for perioperative biomarker elevation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Implementation of the EACTS algorithm led to a similar incidence of PMI but substantially reduced myocardial injury incidence compared to the 4UD while maintaining its clinically relevant association with mortality.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejcts\/ezaf231","type":"journal-article","created":{"date-parts":[[2025,7,9]],"date-time":"2025-07-09T15:55:18Z","timestamp":1752076518000},"source":"Crossref","is-referenced-by-count":1,"title":["Redefinition of Myocardial Infarction After Cardiac Surgery: A two-centre Clinical Evaluation of the Proposed European Association for Cardio-thoracic Surgery Algorithm for the Diagnosis of Perioperative Myocardial Injury and Infarction"],"prefix":"10.1093","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-7342-6674","authenticated-orcid":false,"given":"Maaike S Y","family":"Thio","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care, Amphia Hospital , Breda 4818 CK,","place":["The Netherlands"]},{"name":"Department of Anaesthesiology, Intensive Care and Pain Medicine, St Antonius Hospital , Nieuwegein 3435 CM,","place":["The Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter G","family":"Noordzij","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Intensive Care and Pain Medicine, St Antonius Hospital , Nieuwegein 3435 CM,","place":["The Netherlands"]},{"name":"Department of Anaesthesiology and Intensive Care, University Medical Centre Utrecht , Utrecht, 3584 CX,","place":["The Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henk J T","family":"Ruven","sequence":"additional","affiliation":[{"name":"Department of Clinical Chemistry, St Antonius Hospital , Nieuwegein 3435 CM,","place":["The Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ted","family":"Reniers","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Intensive Care and Pain Medicine, St Antonius Hospital , Nieuwegein 3435 CM,","place":["The Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jurri\u00ebn M","family":"ten Berg","sequence":"additional","affiliation":[{"name":"Department of Cardiology, St Antonius Hospital , Nieuwegein 3435 CM,","place":["The Netherlands"]},{"name":"Maastricht University Medical Center , Maastricht 6229 HX,","place":["The Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rohit M","family":"Oemrawsingh","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Amphia Hospital , Breda 4818 CK,","place":["The Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marloes L P","family":"Langelaan","sequence":"additional","affiliation":[{"name":"Result Laboratorium, Amphia Hospital , Breda 4818 CK,","place":["The Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thijs C D","family":"Rettig","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care, Amphia Hospital , Breda 4818 CK,","place":["The Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,7,9]]},"reference":[{"key":"2025072618325947500_ezaf231-B1","doi-asserted-by":"crossref","first-page":"e618","DOI":"10.1161\/CIR.0000000000000617","article-title":"Fourth universal definition of myocardial infarction 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Perioperative Medicine (StEP) initiative: infection and sepsis","volume":"122","author":"Barnes","year":"2019","journal-title":"Br J Anaesth"},{"key":"2025072618325947500_ezaf231-B8","doi-asserted-by":"crossref","first-page":"734","DOI":"10.1093\/ejcts\/ezs043","article-title":"EuroSCORE II","volume":"41","author":"Nashef","year":"2012","journal-title":"Eur J Cardiothorac Surg"},{"key":"2025072618325947500_ezaf231-B9","first-page":"399","article-title":"The prognostic value of troponin release after adult cardiac surgery\u2014a meta-analysis","volume":"37","author":"Lurati Buse","year":"2010","journal-title":"Eur J Cardiothorac Surg"},{"key":"2025072618325947500_ezaf231-B10","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/j.amjcard.2021.09.049","article-title":"Meta-analysis evaluating high-sensitivity cardiac troponin T kinetics after coronary artery bypass grafting in relation to the current definitions of myocardial infarction","volume":"163","author":"Heuts","year":"2022","journal-title":"Am J Cardiol"},{"key":"2025072618325947500_ezaf231-B11","doi-asserted-by":"crossref","first-page":"1564","DOI":"10.1093\/clinchem\/hvac152","article-title":"High-sensitivity cardiac troponin I and T kinetics differ following coronary bypass surgery: a systematic review and meta-analysis","volume":"68","author":"Denessen","year":"2022","journal-title":"Clin Chem"},{"key":"2025072618325947500_ezaf231-B12","doi-asserted-by":"crossref","first-page":"456","DOI":"10.2459\/JCM.0000000000000044","article-title":"Cardiac troponin I and creatine kinase-MB release after different cardiac surgeries","volume":"16","author":"Mastro","year":"2015","journal-title":"J Cardiovasc Med"}],"container-title":["European Journal of Cardio-Thoracic 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