One out of seven patients aged 65 years and older who undergo surgery that doesn't involve the heart experience damage to heart cells during the procedure or after it. This occurrence is called a perioperative myocardial injury (PMI) and is usually asymptomatic (it does not show any symptoms). PMI is unfamiliar to many medical experts but is strongly associated with death within 30 days after surgery. Patients who have undergone surgery then develop PMI are usually missed because of the lack of symptoms of PMI. When PMI does show signs in some people, it may be mistaken for a heart attack, due to similarities like chest pain.
In order to identify if a patient has damaged heart cells from the non-heart surgery, researchers measured levels of troponin in the blood before and after surgery. Troponin is a heart protein that indicates damage to the heart, even if the patient shows no symptoms of it. High levels of troponin indicate injuries to the heart: the more troponin detected, the more severe the damage. Having high levels of troponin is also associated with a higher risk of mortality.
The people at risk of PMI include older patients who have a high risk of heart disease or patients who have a pre-existing coronary artery disease, peripheral artery disease, or stroke. Researchers found that more than 90 percent of individuals with PMI complained of chest paint, and those who had it were six times more likely to die of any cause within 30 days. This high mortality rate in patients with PMI persists up to one year after the non-heart surgery.
Surgeries observed to cause PMI includes low-risk procedures such as prostate or knee surgery; moderate risk surgeries such as hip replacement or gallbladder removal; and high-risk procedures such as peripheral artery bypass or re-sectioning of the lungs or the liver.
Research is still ongoing, and so far, the causes of PMI have not yet been discovered. However, researchers emphasize that PMI should be recognized as a contributor to death after non-cardiac surgery, to improve the chances of older patients. Since the causes are unknown, no treatment for PMI has been suggested, and symptomatic treatments will have to do for now.
Understanding the study, people who are at high risk of mortality after non-cardiac surgeries include people who have heart disease or have a high risk of developing cardiovascular diseases. That being said, it would be good to keep in mind some strategies to prevent the onset of cardiovascular diseases and other heart- and artery-related disorders.
If you have a family history of cardiovascular disease, then having a healthy lifestyle may decrease the chances of you getting the disease. Furthermore, healthy and active lifestyles also prevent neurodegenerative disorders, which are common as you age. By taking care of yourself as early as now, you take the necessary measures to make sure that you don't develop PMI during or after a non-heart surgery, especially when you get older.