Myocardial Injury Noncardiac Surgery in Geriatric Patients

April 25, 2025 updated by: Mustafa Berkehan Nizamlıoğlu, Fatih Sultan Mehmet Training and Research Hospital

Myocardial Injury in Geriatric Patients Followed in Intensive Care Unit After Noncardiac Surgery

In inpatients aged 45 years and older, the approximate peri-operative mortality rate after non-cardiac surgery is around 1% to 2%. Half of these deaths are attributed to cardiovascular complications of surgery. Postoperative cardiac troponin elevation with ≥1 measurement of cardiac troponin ≥99% percentile above the upper limit of the reference value, which is an indicator of acute myocardial injury, is seen in the first 30 days after surgery and usually occurs within 72 hours. Myocardial damage is thought to result from an ischemic mechanism. Clinical symptoms may be masked by sedation or analgesia in the perioperative period, so evidence of an ischemic feature (e.g. ischemic symptoms, electrocardiographic changes) is not required. These criteria are defined as MINS (Myocardial Injury Non Cardiac Surgery) criteria. In this study, the investigators aimed to investigate the intensive care follow-up processes and outcomes of geriatric patients over 65 years of age in whom MINS was detected during postoperative intensive care monitoring.

Study Overview

Status

Completed

Conditions

Myocardial Injury After Noncardiac Surgery (MINS)

Detailed Description

In this study study, 117 geriatric patients aged ≥65 years who were followed and treated in the intensive care unit in the postoperative period after general or regional anesthesia between January 2018 and August 2023 after obtaining Ethics Committee Approval (FSM EAH-KAEK 2023/140) were retrospectively analyzed. Age, gender, comorbidities, coronary artery disease, heart failure, atrial fibrillation, history of chronic renal failure, presence of emergency surgery, preoperative antiaggregant use, ASA score, type of surgery, presence of laparoscopic or open surgery, anesthesia and duration of surgery, intra operatively; hypotension, tachycardia, bradycardia, presence of blood and blood products transfusion, duration if hypotension developed, first day of intensive care unit hospitalization; APACHE, SAPS, SOFA scores, duration of mechanical ventilation, presence and duration of troponin elevation, the day of hospitalization, if cardiac examination was performed; Ejection fraction, diastolic dysfunction, presence of revascularization treatment, hemoglobin, hematocrit levels on the day of troponin elevation, neutrophil/lymphocyte ratio, procalcitonin, crp levels, use of antiaggregants, mechanical thrombophylaxis, acidosis, presence of hypoxia, need for vasopressor therapy, type of discharge from intensive care unit and presence of mortality will be recorded

Study Type

Observational

Enrollment (Actual)

117

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

Turkey
- Atasehir
  - Istanbul, Atasehir, Turkey, 34752
    - Fatih Sultan Mehmet Training and Research Hospital,

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

Older Adult

Accepts Healthy Volunteers

Sampling Method

Non-Probability Sample

Study Population

This study includes geriatric patients aged 65 years and older who underwent major, moderate, or minor surgery under general and/or regional anesthesia and were followed postoperatively in the intensive care unit between January 2018 and August 2023 at Fatih Sultan Mehmet Training and Research Hospital. The study population consists of patients whose medical records were retrospectively reviewed.

Description

Inclusion Criteria:

Patients aged 65 years or older
Patients who underwent major, moderate, or minor surgery under general and/or regional anesthesia
Patients who were followed and treated in the postoperative intensive care unit

Exclusion Criteria:

Patients younger than 65 years of age
Patients with preoperative troponin levels above the normal reference range
Patients with active myocardial ischemia symptoms (e.g., chest pain, pain radiating to the neck, jaw, shoulder, or arm)
Patients with known pre-existing cardiac disease

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Number of groups / cohorts

Cohorts and Interventions

Group / Cohort
Geriatric ICU Patients Geriatric patients (aged ≥65 years) who underwent surgery under general or regional anesthesia and were admitted to the intensive care unit in the postoperative period between January 2018 and August 2023.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
30-day postoperative mortality Time Frame: 30 days	Association between postoperative troponin elevation and ICU mortality in geriatric patients. Mortality status recorded in hospital database	30 days

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
mechanical ventilation Time Frame: 30 days	Duration of mechanical ventilation in patients over 65 years of age with postoperative mins.	30 days

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Fatih Sultan Mehmet Training and Research Hospital

Investigators

Study Director: Arzu Yildirim Ar, As Prof, Fatih Sultan Mehmet Training and Research Hospital

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

January 1, 2018

Primary Completion (Actual)

August 1, 2023

Study Completion (Actual)

August 1, 2023

Study Registration Dates

First Submitted

April 21, 2025

First Submitted That Met QC Criteria

April 25, 2025

First Posted (Actual)

May 4, 2025

Study Record Updates

Last Update Posted (Actual)