Perioperative medicine & outcomes
Aetiology and associated outcomes of myocardial injury as defined by postoperative troponin elevation in high-risk patients after noncardiac surgery: a single-centre retrospective cohort study
Authors' conclusion
In this single-centre high-risk noncardiac surgical cohort, pragmatic aetiological assessment attributed myocardial injury more often to extra-cardiac mechanisms, which were associated with higher in-hospital mortality.
Study context
- Population
- High-risk adults with myocardial injury (hs-cTnT >50 ng L-1 within 72 h) after noncardiac surgery, selectively tested, 2017 to 2022analysed
- Participants
- 954 adults
- Exposure
- Extra-cardiac vs cardiac aetiology of myocardial injury
- Extra-cardiacn = 544
- Cardiacn = 410reference
- Outcome
- Aetiological distribution (extra-cardiac or cardiac), adjudicated by anaesthetists using an existing hierarchical model
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
Aetiological distribution
- Most common extra-cardiac cause: renal failure
- 37%
- Most common cardiac cause: type 2 myocardial injury
- 81%
Observational data: associations, not effects.
Secondary outcomes
In-hospital mortality
P = 0.002
Non-elective surgery
P < 0.001
- In-hospital mortality — Overall in-hospital mortality
- 20%
Inter-rater agreement after reassessment
- Agreement
- 78%
- κ
- 0.55
- Discrepancies mainly in type 2 myocardial injury
Original publication
Aetiology and associated outcomes of myocardial injury as defined by postoperative troponin elevation in high-risk patients after noncardiac surgery: a single-centre retrospective cohort study. BJA Open. Published 13 August 2026. doi:10.
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