Incidence of Postoperative Myocardial Injury in Non-Cardiac Surgery – A Prospective Cohort Study (Code-T0308)

Introduction: Myocardial injury after non-cardiac surgery (MINS) is a critical yet often
overlooked postoperative complication. It is strongly associated with increased morbidity and
mortality, primarily resulting from ischemic myocardial damage. Early identification of high-risk
patients and understanding predictors of MINS can significantly improve perioperative
outcomes.
Aims and Objectives:
Primary: To identify incidence of myocardial injury after noncardiac surgery
Secondary
To identify the major predictors of MINS
To assess the prognosis and mortality rates of patients developing MINS
Methods: A prospective cohort study was conducted at Kozhikode District Co-operative
Hospital over 24 months, enrolling 162 patients aged ≥50 years undergoing non-cardiac surgery.
Serial Troponin I (Trop I) measurements and electrocardiogram (ECG) assessments were
performed preoperatively and postoperatively. Clinical and intraoperative variables were
analyzed to determine significant risk factors for MINS.
Results: MINS was observed in 26 (16.04%) patients. Significant predictors included diabetes
(p=0.002), dyslipidemia (p=0.015), coronary artery disease (p<0.0005), cerebrovascular
accidents (p<0.0003), prolonged surgery duration (>3.5 hours, p<0.0001), and higher ASA grade
(≥3, p<0.0002). Postoperative mortality was significantly higher among MINS-positive patients
(p=0.0003).
Conclusion: MINS is a prevalent and serious postoperative complication that substantially
increases the risk of adverse outcomes. Routine postoperative Trop I screening, risk
stratification, and targeted perioperative management strategies are essential to mitigate MINSrelated
morbidity and mortality.
Keywords: Myocardial Injury, Non-Cardiac Surgery, Troponin I, Perioperative Risk,
Postoperative Complications, Surgical Outcomes.