AUTHOR=Gao Linggen , Chen Lei , He Jing , Wang Bin , Liu Chaoyang , Wang Rong , Fan Li , Cheng Rui 

TITLE=Perioperative Myocardial Injury/Infarction After Non-cardiac Surgery in Elderly Patients

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 9 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2022.910879

DOI=10.3389/fcvm.2022.910879

ISSN=2297-055X

ABSTRACT=The number of surgical operations on elderly patients grows rapidly. Elderly surgical patients with multiple comorbidities have a higher risk of postoperative myocardial injury (PMI). PMI has been identified as cardiac troponin elevation caused by ischemia that occurs during or within 30 days after surgery with substantial short- and long-term mortality. Perioperative troponin screening is recommended in the elderly. The pathophysiology of PMI mainly results from either increased myocardial oxygen demand and/or decreased myocardial oxygen delivery. The main causes result in significant myocardial oxygen supply/demand mismatch after surgery include the pre-operative, intra-operative, and post-operative risk factors. The treatment strategy is firstly focused around the risk factors and guideline-directed medical therapy. Cardiovascular medical treatments, such as antiplatelets, β-blockers, statins, and angiotensin-converting enzyme inhibitors have shown improved outcomes in patients with PMI. The surgical risk of bleeding should be considered before using antiplatelets and anticoagulation.