Perioperative MI following major non-cardiac surgery frequent and tied to MACE

A new study conducted by Christian Puelacher and team showed that at 1 year, Major adverse cardiac events (MACEs) and all-cause mortality rates are unacceptably high for the majority of Perioperative myocardial infarction/injury (PMI) etiologies, underscoring the urgent need for more intensive therapies. The findings of this study were published in European Heart Journal.

A key factor in post-operative mortality and a common perioperative cardiac complication following major non-cardiac surgery is perioperative myocardial infarction/injury. Active monitoring for PMI has been used in previous research, which has shown that the condition is not a single, homogenous disease but rather a heterogeneous syndrome with a variety of underlying etiologies. Because of this, a comprehensive prospective multicenter research was done to analyze significant adverse cardiac events and all-cause mortality linked to various centrally adjudicated PMI etiologies within a year.

In a prospective multicenter study, the etiologies of PMIs discovered as part of an active surveillance and response program were centrally adjudicated by two independent doctors based on all data gathered during clinically indicated PMI work-up, including cardiac imaging, among consecutive high-risk patients undergoing major non-cardiac surgery. Acute heart failure (AHF), tachyarrhythmia, type 1 myocardial infarction (T1MI), severe sepsis, pulmonary embolism, and probable type 2 myocardial infarction are all cardiac diseases that can produce PMI. Extra-cardiac diseases include conditions like severe sepsis and pulmonary embolism (lT2MI).