Perioperative medicine & outcomes
Myocardial injury and short- and long-term outcomes after oncological surgery: A large-scale retrospective cohort study
Main finding · MINS incidence and 30-day mortalityResult — go to the resultAdjusted hazard ratio 7.10 95 % CI 4.21–11.97Authors' conclusion
MINS is common, largely asymptomatic, and strongly associated with both early and late mortality after oncological surgery.
Study context
- Population
- Adults undergoing intermediate-to-high-risk oncological surgery with postoperative high-sensitivity troponin I (hsTnI) measurements, September 2013–September 2022
- Participants
- 6,277 adults
- Exposure
- MINS vs no MINS; peak hsTnI dose-response
- Outcome
- Mortality and MACE
- Follow-up
- 30 days
Methodological detailslandmark analysis, flexible parametric survival model
- Landmark analysis
- Flexible parametric survival model
Main finding
MINS incidence and 30-day mortality
Adjusted hazard ratio
7.10
95 % CI 4.21–11.97
P < 0.001
MINS vs No MINS
aHR 7.10 (95 % CI 4.21–11.97); P < 0.001
As reported in the abstract
- MINS incidence (after excluding 22 nonischemic troponin elevations)
- 19.1 %
- MINS asymptomatic
- 98.7 %
- Population-attributable risk of 30-day mortality due to MINS
- 53.8 %
- 30-day mortality per SD increase in log hsTnI, aHR
- 2.33 (95 % CI 1.94-2.80; P < 0.001)
- 30-day major adverse cardiovascular events (MACE) per SD increase in log hsTnI, aHR
- 3.91 (95 % CI 3.47-4.42; P < 0.001)
Observational data: associations, not effects.
Further findings
30-day mortality prediction with MINS added
- C-index 0.831 vs 0.797; ΔC-index (P = 0.090)
- 0.034
- Net reclassification improvement
- 31.51 %
- Integrated discrimination improvement
- 0.037
Mortality, landmark analysis · 365 days
- Increased risk within 30 days (fold)
- 8.1
- Sustained risk from day 31 to 365 (fold)
- 1.8
- Flexible parametric survival model (FPSM): sustained excess mortality hazard throughout the year
Original publication
Myocardial injury and short- and long-term outcomes after oncological surgery: A large-scale retrospective cohort study. J Clin Anesth. Published 10 September 2025. doi:10.
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