{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T18:25:11Z","timestamp":1787163911137,"version":"build-2736575974"},"reference-count":44,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,5,19]],"date-time":"2022-05-19T00:00:00Z","timestamp":1652918400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:p>At present, we have entered an aging society. Many diseases suffered by the elderly, such as malignant tumors, cardiovascular diseases, fractures, surgical emergencies and so on, need surgical intervention. With the improvement of Geriatrics, surgical minimally invasive technology and anesthesia level, more and more elderly patients can safely undergo surgery. Elderly surgical patients are often complicated with a variety of chronic diseases, and the risk of postoperative myocardial injury\/infarction (PMI) is high. PMI is considered to be the increase of cardiac troponin caused by perioperative ischemia, which mostly occurs during operation or within 30 days after operation, which can increase the risk of short-term and long-term death. Therefore, it is suggested to screen troponin in elderly patients during perioperative period, timely identify patients with postoperative myocardial injury and give appropriate treatment, so as to improve the prognosis. The pathophysiological mechanism of PMI is mainly due to the increase of myocardial oxygen consumption and \/ the decrease of myocardial oxygen supply. Preoperative and postoperative risk factors of myocardial injury can be induced by mismatch of preoperative and postoperative oxygen supply. The treatment strategy should first control the risk factors and use the drugs recommended in the guidelines for treatment. Application of cardiovascular drugs, such as antiplatelet \u03b2- Receptor blockers, statins and angiotensin converting enzyme inhibitors can effectively improve postoperative myocardial ischemia. However, the risk of perioperative bleeding should be fully considered before using antiplatelet and anticoagulant drugs. This review is intended to describe the epidemiology, diagnosis, pathophysiology, risk factors, prognosis and treatment of postoperative myocardial infarction \/injury.<\/jats:p>","DOI":"10.3389\/fcvm.2022.910879","type":"journal-article","created":{"date-parts":[[2022,5,19]],"date-time":"2022-05-19T01:25:21Z","timestamp":1652923521000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":25,"title":["Perioperative Myocardial Injury\/Infarction After Non-cardiac Surgery in Elderly Patients"],"prefix":"10.3389","volume":"9","author":[{"given":"Linggen","family":"Gao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chaoyang","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rong","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Fan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,5,19]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"523","DOI":"10.7326\/0003-4819-154-8-201104190-00003","article-title":"Characteristics and short-term prognosis of perioperative myocardial infarction in patients undergoing noncardiac surgery: a cohort study","volume":"154","author":"Devereaux","year":"2011","journal-title":"Ann Intern Med."},{"key":"B2","doi-asserted-by":"publisher","first-page":"559","DOI":"10.1093\/bja\/aew321","article-title":"Troponin elevations after non-cardiac, non-vascular surgery are predictive of major adverse cardiac events and mortality: a systematic review and meta-analysis","volume":"117","author":"Ekeloef","year":"2016","journal-title":"Br J Anaesth."},{"key":"B3","doi-asserted-by":"publisher","first-page":"1221","DOI":"10.1161\/CIRCULATIONAHA.117.030114","article-title":"Perioperative myocardial injury after noncardiac surgery: incidence, mortality, and characterization","volume":"137","author":"Puelacher","year":"2018","journal-title":"Circulation."},{"key":"B4","doi-asserted-by":"publisher","first-page":"2264","DOI":"10.1161\/CIRCULATIONAHA.113.002128","article-title":"Myocardial injury after noncardiac surgery and its association with short-term mortality","volume":"127","author":"van Waes","year":"2013","journal-title":"Circulation."},{"key":"B5","doi-asserted-by":"publisher","first-page":"2295","DOI":"10.1001\/jama.2012.5502","article-title":"Association between postoperative troponin levels and 30-day mortality among patients undergoing noncardiac surgery","volume":"307","author":"Vascular Events In Noncardiac Surgery Patients Cohort Evaluation Study","year":"2012","journal-title":"JAMA."},{"key":"B6","doi-asserted-by":"publisher","first-page":"1642","DOI":"10.1001\/jama.2017.4360","article-title":"Association of postoperative high-sensitivity troponin levels with myocardial injury and 30-day mortality among patients undergoing noncardiac surgery","volume":"317","author":"Biccard","year":"2017","journal-title":"JAMA."},{"key":"B7","doi-asserted-by":"publisher","first-page":"e005672","DOI":"10.1161\/JAHA.117.005672","article-title":"Associations between cardiac troponin, mechanism of myocardial injury, and long-term mortality after noncardiac vascular surgery","volume":"6","author":"Reed","year":"2017","journal-title":"J Am Heart Assoc."},{"key":"B8","doi-asserted-by":"publisher","first-page":"564","DOI":"10.1097\/ALN.0000000000000113","article-title":"Myocardial injury after noncardiac surgery: a large, international, prospective cohort study establishing diagnostic criteria, characteristics, predictors, and 30-day outcomes","volume":"120","author":"Botto","year":"2014","journal-title":"Anesthesiology."},{"key":"B9","doi-asserted-by":"publisher","first-page":"267","DOI":"10.1097\/CRD.0000000000000254","article-title":"Myocardial injury after noncardiac surgery: a systematic review and meta-analysis","volume":"27","author":"Smilowitz","year":"2019","journal-title":"Cardiol Rev."},{"key":"B10","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1001\/jamacardio.2016.4792","article-title":"Perioperative major adverse cardiovascular and cerebrovascular events associated with noncardiac surgery","volume":"2","author":"Smilowitz","year":"2017","journal-title":"JAMA Cardiol."},{"key":"B11","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1016\/j.bja.2020.08.056","article-title":"Association between postoperative haemoglobin and myocardial injury after noncardiac surgery: a retrospective cohort analysis","volume":"126","author":"Turan","year":"2021","journal-title":"Br J Anaesth."},{"key":"B12","doi-asserted-by":"publisher","first-page":"357","DOI":"10.1097\/SLA.0000000000002290","article-title":"Myocardial injury after noncardiac surgery (MINS) in vascular surgical patients: a prospective observational cohort study","volume":"268","author":"Biccard","year":"2018","journal-title":"Ann Surg."},{"key":"B13","doi-asserted-by":"publisher","first-page":"3083","DOI":"10.1093\/eurheartj\/ehz301","article-title":"Myocardial injury after non-cardiac surgery: diagnosis and management","volume":"41","author":"Devereaux","year":"2020","journal-title":"Eur Heart J."},{"key":"B14","doi-asserted-by":"publisher","first-page":"880","DOI":"10.2106\/JBJS.18.01305","article-title":"Association between myocardial injury and cardiovascular outcomes of orthopaedic surgery: a vascular events in noncardiac surgery patients cohort evaluation (VISION) substudy","volume":"102","author":"Thomas","year":"2020","journal-title":"J Bone Joint Surg Am."},{"key":"B15","doi-asserted-by":"publisher","first-page":"1450","DOI":"10.1007\/s00392-021-01827-w","article-title":"Incidence and outcomes of perioperative myocardial infarction\/injury diagnosed by high-sensitivity cardiac troponin I","volume":"110","author":"Gualandro","year":"2021","journal-title":"Clin Res Cardiol."},{"key":"B16","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1016\/j.cjca.2016.09.008","article-title":"Canadian cardiovascular society guidelines on perioperative cardiac risk assessment and management for patients who undergo noncardiac surgery","volume":"33","author":"Duceppe","year":"2017","journal-title":"Can J Cardiol."},{"key":"B17","doi-asserted-by":"publisher","first-page":"2231","DOI":"10.1016\/j.jacc.2018.08.1038","article-title":"Fourth universal definition of myocardial infarction","volume":"72","author":"Thygesen","year":"2018","journal-title":"J Am Coll Cardiol."},{"key":"B18","doi-asserted-by":"publisher","first-page":"283","DOI":"10.1046\/j.1365-2796.2002.01019.x","article-title":"Inflammatory bio-markers and cardiovascular risk prediction","volume":"252","author":"Blake","year":"2002","journal-title":"J Intern Med."},{"key":"B19","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1042\/cs0790161","article-title":"Response of serum interleukin-6 in patients undergoing elective surgery of varying severity","volume":"79","author":"Cruickshank","year":"1990","journal-title":"Clin Sci."},{"key":"B20","doi-asserted-by":"publisher","first-page":"1557","DOI":"10.1056\/NEJMoa021993","article-title":"Comparison of C-reactive protein and low-density lipoprotein cholesterol levels in the prediction of first cardiovascular events","volume":"347","author":"Ridker","year":"2002","journal-title":"N Engl J Med."},{"key":"B21","doi-asserted-by":"publisher","first-page":"1084","DOI":"10.1097\/ALN.0000000000002107","article-title":"Etiology of acute coronary syndrome after noncardiac surgery","volume":"128","author":"Helwani","year":"2018","journal-title":"Anesthesiology."},{"key":"B22","doi-asserted-by":"publisher","first-page":"725","DOI":"10.1016\/j.bja.2017.11.063","article-title":"Incidence of thrombosis in perioperative and non-operative myocardial infarction","volume":"120","author":"Sheth","year":"2018","journal-title":"Br J Anaesth."},{"key":"B23","doi-asserted-by":"publisher","first-page":"h1907","DOI":"10.1136\/bmj.h1907","article-title":"Prognostic capabilities of coronary computed tomographic angiography before non-cardiac surgery: prospective cohort study","volume":"350","author":"Sheth","year":"2015","journal-title":"BMJ."},{"key":"B24","doi-asserted-by":"publisher","first-page":"2409","DOI":"10.1093\/eurheartj\/ehx313","article-title":"Perioperative acute myocardial infarction associated with non-cardiac surgery","volume":"38","author":"Smilowitz","year":"2017","journal-title":"Eur Heart J."},{"key":"B25","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1037\/e623972009-001","article-title":"Health characteristics of adults aged 55 years and over: United States, 2004-2007","volume":"16","author":"Schoenborn","year":"2009","journal-title":"Natl Health Stat Rep."},{"key":"B26","doi-asserted-by":"publisher","first-page":"547","DOI":"10.26355\/eurrev_201801_14208","article-title":"Role of surgical setting and patients-related factors in predicting the occurrence of postoperative pulmonary complications after abdominal surgery","volume":"22","author":"Perilli","year":"2018","journal-title":"Eur Rev Med Pharmacol Sci."},{"key":"B27","doi-asserted-by":"publisher","first-page":"240","DOI":"10.1213\/00000539-199003000-00002","article-title":"Angina and other risk factors in patients with cardiac diseases undergoing noncardiac operations","volume":"70","author":"Shah","year":"1990","journal-title":"Anesth Analg."},{"key":"B28","doi-asserted-by":"publisher","first-page":"857","DOI":"10.1097\/SLA.0b013e3182125196","article-title":"Risk of surgery following recent myocardial infarction","volume":"253","author":"Livhits","year":"2011","journal-title":"Ann Surg."},{"key":"B29","doi-asserted-by":"publisher","first-page":"958","DOI":"10.1016\/j.jcin.2014.05.011","article-title":"Mechanisms of atherothrombosis and vascular response to primary percutaneous coronary intervention in women versus men with acute myocardial infarction: results of the OCTAVIA study","volume":"7","author":"Guagliumi","year":"2014","journal-title":"JACC Cardiovasc Interv."},{"key":"B30","doi-asserted-by":"publisher","first-page":"394","DOI":"10.1093\/eurheartj\/ehm620","article-title":"Predictors and outcomes of a perioperative myocardial infarction following elective vascular surgery in patients with documented coronary artery disease: results of the CARP trial","volume":"29","author":"McFalls","year":"2008","journal-title":"Eur Heart J."},{"key":"B31","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1016\/j.mayocp.2016.08.005","article-title":"Postoperative tachycardia: clinically meaningful or benign consequence of orthopedic surgery?","volume":"92","author":"Sigmund","year":"2017","journal-title":"Mayo Clin Proc."},{"key":"B32","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1097\/ALN.0000000000000922","article-title":"Association between Intraoperative hypotension and myocardial injury after vascular surgery","volume":"124","author":"van Waes","year":"2016","journal-title":"Anesthesiology."},{"key":"B33","doi-asserted-by":"publisher","first-page":"507","DOI":"10.1097\/ALN.0b013e3182a10e26","article-title":"Relationship between intraoperative mean arterial pressure and clinical outcomes after noncardiac surgery: toward an empirical definition of hypotension","volume":"119","author":"Walsh","year":"2013","journal-title":"Anesthesiology."},{"key":"B34","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1016\/j.jcrc.2017.01.011","article-title":"Acute kidney injury is an independent risk factor for myocardial injury after noncardiac surgery in critical patients","volume":"39","author":"Zhao","year":"2017","journal-title":"J Crit Care."},{"key":"B35","doi-asserted-by":"publisher","first-page":"450","DOI":"10.1097\/EJA.0000000000000429","article-title":"Intraoperative hypotension is associated with myocardial damage in noncardiac surgery: an observational study","volume":"33","author":"Hallqvist","year":"2016","journal-title":"Eur J Anaesthesiol."},{"key":"B36","doi-asserted-by":"publisher","first-page":"1936","DOI":"10.1213\/ANE.0000000000002560","article-title":"A prospective international multicentre cohort study of intraoperative heart rate and systolic blood pressure and myocardial injury after noncardiac surgery: results of the VISION study","volume":"126","author":"Abbott","year":"2018","journal-title":"Anesth Analg."},{"key":"B37","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1016\/j.bja.2020.08.054","article-title":"Association between postoperative haemoglobin concentrations and composite of non-fatal myocardial infarction and all-cause mortality in noncardiac surgical patients: post hoc analysis of the POISE-2 trial","volume":"126","author":"Turan","year":"2021","journal-title":"Br J Anaesth."},{"key":"B38","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1016\/j.bja.2020.06.048","article-title":"A restrictive versus liberal transfusion strategy to prevent myocardial injury in patients undergoing surgery for fractured neck of femur: a feasibility randomised trial (RESULT-NOF)","volume":"126","author":"Gillies","year":"2021","journal-title":"Br J Anaesth."},{"key":"B39","doi-asserted-by":"publisher","first-page":"381","DOI":"10.1161\/CIRCULATIONAHA.110.015701","article-title":"Development and validation of a risk calculator for prediction of cardiac risk after surgery","volume":"124","author":"Gupta","year":"2011","journal-title":"Circulation."},{"key":"B40","doi-asserted-by":"publisher","first-page":"833","DOI":"10.1016\/j.jamcollsurg.2013.07.385","article-title":"Development and evaluation of the universal ACS NSQIP surgical risk calculator: a decision aid and informed consent tool for patients and surgeons","volume":"217","author":"Bilimoria","year":"2013","journal-title":"J Am Coll Surg."},{"key":"B41","doi-asserted-by":"publisher","first-page":"2246","DOI":"10.1161\/CIR.0000000000000104","article-title":"Perioperative beta blockade in noncardiac surgery: a systematic review for the 2014 ACC\/AHA guideline on perioperative cardiovascular evaluation and management of patients undergoing noncardiac surgery: a report of the American college of cardiology\/American heart association task force on practice guidelines","volume":"130","author":"Wijeysundera","year":"2014","journal-title":"Circulation."},{"key":"B42","doi-asserted-by":"publisher","first-page":"1013","DOI":"10.1007\/s12630-012-9782-9","article-title":"Use of clinically based troponin underestimates the cardiac injury in non-cardiac surgery: a single-centre cohort study in 51,701 consecutive patients","volume":"59","author":"Beattie","year":"2012","journal-title":"Can J Anaesth."},{"key":"B43","doi-asserted-by":"publisher","first-page":"11616","DOI":"10.1038\/s41598-020-68511-3","article-title":"Postoperative statin treatment may be associated with improved mortality in patients with myocardial injury after noncardiac surgery","volume":"10","author":"Park","year":"2020","journal-title":"Sci Rep."},{"key":"B44","doi-asserted-by":"publisher","first-page":"794","DOI":"10.1097\/ALN.0b013e3181f1c061","article-title":"Association of the pattern of use of perioperative beta-blockade and postoperative mortality","volume":"113","author":"Wallace","year":"2010","journal-title":"Anesthesiology."}],"container-title":["Frontiers in Cardiovascular Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2022.910879\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,19]],"date-time":"2022-05-19T01:25:27Z","timestamp":1652923527000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2022.910879\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,19]]},"references-count":44,"alternative-id":["10.3389\/fcvm.2022.910879"],"URL":"https:\/\/doi.org\/10.3389\/fcvm.2022.910879","relation":{},"ISSN":["2297-055X"],"issn-type":[{"value":"2297-055X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,5,19]]},"article-number":"910879"}}