Myocardial injury after noncardiac surgery (MINS) includes patients with traditional myocardial infarction and those with ischemic myocardial injury after surgery. This study evaluated the prognostic value of MINS on major cardiovascular events and 30-day mortality, and determined independent preoperative predictors of MINS in patients after noncardiac surgery. This multicenter prospective cohort study was part of the VISION Study. The sample consisted of 2504 patients who underwent noncardiac surgery at 2 tertiary hospitals in Brazil between September 2008 and July 2012. Troponin Ts were measured 6-12 hours, and on days 1-3 after surgery. Cox regression analyses were performed to identify independent variables of major outcomes. A total of 314 (13%) patients were diagnosed with MINS, of which 26 (8%) died. Length-of-hospital stay of MINS patients was 3 times higher (18 ± 22 days vs 5.8 ± 11 days). In multivariate analysis, 30-day mortality was significantly higher among patients with MINS (hazard ratio [HR] 3.17 (95% confidence interval [CI] 1.56-6.41)), and major bleeding (HR 5.76 (95% CI 2.75-12.05)), sepsis (HR 5.08 (95% CI 2.25-11.46)), active cancer (HR 4.22 (95% CI 1.98-8.98)), and general surgery (HR 3.11 (95% CI 1.51-6.41)). Multivariable analysis indicated a higher chance of MINS in patients ≥75 years of age, history of diabetes mellitus, hypertension, heart failure, coronary disease, and end-stage renal failure. The incidence of MINS within 30 days after noncardiac surgery is related to higher mortality. Postoperative troponin monitoring in elder patients and with risk factors for atherosclerotic disease may help reduce postoperative cardiovascular events.

中文翻译：

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围手术期肌钙蛋白筛选标识患者在风险较高的非心脏手术主要心血管事件。

后非心脏手术（分钟）心肌损伤包括患者与传统的心肌梗死和那些手术后缺血性心肌损伤。本研究评估了 MINS 对主要心血管事件和 30 天死亡率的预后价值，并确定了非心脏手术后患者 MINS 的独立术前预测因子。这项多中心前瞻性队列研究是VISION研究的一部分。样本包括2504例谁在巴西2家三级医院2008年9月和2012年7月肌钙蛋白TS之间进行非心脏手术的测定6-12小时，并在第1-3天手术后。进行Cox回归分析，以确定主要成果的独立变量。共有314（13％）患者被诊断为MINS，其中26（8％）的死亡。长度的 - 医院逗留MINS患者为3倍（18±22天与5.8±11天）。在多变量分析中，30天的死亡率为患者中显著高于MINS [风险比（HR] 3.17（95％置信区间[CI] 1.56-6.41）），和大出血（HR 5.76（95％CI 2.75-12.05） ），败血症（HR 5.08（95％CI 2.25-11.46）），活性癌症（HR 4.22（95％CI 1.98-8.98）），和普通外科（HR 3.11（95％CI 1.51-6.41））。多变量分析显示敏思患者≥75岁，糖尿病，高血压，心脏衰竭，冠心病，终末期肾功能衰竭的历史的机会较高。敏思的30天之内非心脏手术后的发病率与死亡率较高。