Prevalence and prognostic relevance of perioperative myocardial injury/infarction after major noncardiac surgery in older patients.
Background The prognostic relevance of perioperative myocardial injury/infarction (PMI) in older patients undergoing major noncardiac surgery remains unclear, as high comorbidity burden may lessen its impact. Methods Older patients (defined as age ≥70 years with ≥3 comorbidities, or ≥80 years) enrol...
| Publicado en: | Age & Ageing Vol. 55; no. 4; pp. 1 - 11 |
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| Autores principales: | , , , , , , , , , |
| Formato: | Artículo |
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Oxford University Press / USA
Apr2026
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| Materias: | |
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=193500098&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 193500098 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 00020729 AGA jtl: Age & Ageing issn: 00020729 maglogo: N pubinfo: dt: Apr2026 vid: 55 iid: 4 pid: 622 pub: Oxford University Press / USA artinfo: ui: 193500098 10.1093/ageing/afag103 ppf: 1 ppct: 10 formats: tig: atl: Prevalence and prognostic relevance of perioperative myocardial injury/infarction after major noncardiac surgery in older patients. aug: au: Ergin, Emre Durak, Koray Glarner, Noemi Haziri, Fisnik Burri-Winkler, Katrin Kaplan, Emel Huré, Gabrielle Thommen, Vanessa Pargger, Mirjam Usai, Edoardo affil: Department of Cardiology, University Hospital Basel, Basel, Basel-Stadt, SwitzerlandCardiovascular Research Institute Basel, University Hospital Basel, Basel, Basel-Stadt, Switzerland Department of Cardiology, University Hospital Basel, Basel, Basel-Stadt, SwitzerlandCardiovascular Research Institute Basel, University Hospital Basel, Basel, Basel-Stadt, SwitzerlandAnesthesiology, University Hospital Basel, Basel, Basel-Stadt, Switzerland su: Switzerland Brazil Patients Age distribution Disease risk factors Old age Myocardial infarction complications Mortality risk factors Myocardial infarction Risk assessment Troponin Surgery Academic medical centers Secondary analysis Major adverse cardiovascular events Hemoglobins Descriptive statistics Functional status Operative surgery Surgical complications Myocardial injury Longitudinal method Research Confidence intervals Data analysis software Proportional hazards models Regression analysis Sensitivity & specificity (Statistics) Comorbidity Disease complications sug: subj: Patients Age distribution Disease risk factors Old age Switzerland Brazil Myocardial infarction complications Mortality risk factors Myocardial infarction Risk assessment Troponin Surgery Academic medical centers Secondary analysis Major adverse cardiovascular events Hemoglobins Descriptive statistics Functional status Operative surgery Surgical complications Myocardial injury Longitudinal method Research Confidence intervals Data analysis software Proportional hazards models Regression analysis Sensitivity & specificity (Statistics) Comorbidity Disease complications keyword: acute ageing aging cardiac arrhythmia cardiac event cardiovascular cardiovascular death cardiovascular system comorbidity copyrightHolder:British Geriatrics Society copyrightYear:2026 geriatric surgery heart disease risk factors heart failure https://dx.doi.org/10.1093/ageing/afag103 infarction inLanguage:en mortality myocardial infarction myocardial injury older adult older people operative patient prognosis perioperative perioperative care publisher:Oxford University Press sameAs:https://pubmed.ncbi.nlm.nih.gov/42003350/ surgical procedures surrogate endpoints acute ageing aging cardiac arrhythmia cardiac event cardiovascular cardiovascular death cardiovascular system comorbidity copyrightHolder:British Geriatrics Society copyrightYear:2026 geriatric surgery heart disease risk factors heart failure https://dx.doi.org/10.1093/ageing/afag103 infarction inLanguage:en mortality myocardial infarction myocardial injury older adult older people operative patient prognosis perioperative perioperative care publisher:Oxford University Press sameAs:https://pubmed.ncbi.nlm.nih.gov/42003350/ surgical procedures surrogate endpoints ab: Background The prognostic relevance of perioperative myocardial injury/infarction (PMI) in older patients undergoing major noncardiac surgery remains unclear, as high comorbidity burden may lessen its impact. Methods Older patients (defined as age ≥70 years with ≥3 comorbidities, or ≥80 years) enrolled in a multicentre, prospective study of patients at increased cardiovascular risk undergoing major noncardiac surgery were analysed. The primary endpoint, all-cause mortality at 1 year, was analysed using Cox proportional hazards regression. Secondary endpoints included major adverse cardiac events (MACE) (cardiovascular death, acute myocardial infarction, life-threatening arrhythmia and acute heart failure), analysed using Fine–Grey hazard regression. All models were adjusted for prespecified confounders with PMI as a time-varying exposure. Results Amongst 4634 older patients (median age 80 years; 42.9% women), PMI occurred in 892 patients (19.2%), which was higher than in younger patients (P < .0001). The distribution of PMI aetiologies was comparable between groups. At 1 year, all-cause mortality was 26.2% in patients with PMI and 13.2% in patients without PMI, and MACE occurred in 30% versus 13%, respectively. After multivariable adjustment, the hazard ratio of PMI was highest on postoperative day 1 (all-cause mortality: 10.5 [95% CI 4.5–24.5]; MACE: 4.4 [95% CI 3.2–5.9]), declined by day 90 (1.4 [95% CI 1.0–1.9] and 2.2 [95% CI 1.7–2.7], respectively), and persisted through 1 year. Conclusions PMI was very common amongst older patients and associated with substantially higher 1-year risks of all-cause mortality and MACE, with greatest vulnerability observed during the initial 90 postoperative days. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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