AbstractIn this edition of the journal, Drs Kisten and Biccard have published an interesting article evaluating the incidence and in-hospital mortality among patients suffering a perioperative myocardial infarction (PMI) and myocardial injury after noncardiac surgery (MINS) in a retrospective cohort of 140 vascular surgery patients admitted to an intensive care unit (ICU) after surgery.1 The authors defined PMI based on the Third Universal Definition of Myocardial Infarction2 and used a Siemens troponin I threshold of ≥ 600 ng/L and MINS based on a troponin I of 41 to 599 ng/L that was adjudicated as resulting from an ischaemic aetiology. PMI occurred in 34 patients (24.3%) and MINS in 35 patients (25.0%). The incidence of in-hospital mortality among patients who did not suffer PMI or MINS, had MINS, and had PMI was 18.3%, 20.0%, and 58.8% respectively. A multivariable model that included PMI, MINS, and postoperative brain natriuretic peptide demonstrated that only PMI was associated with in-hospital mortality (odds ratio, 4.3; 95% confidence interval [CI], 1.4–12.9).1
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