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非心脏手术后心肌损伤的综合综述:预防、干预及长期管理策略

Comprehensive review of myocardial injury after noncardiac surgery: prevention, intervention, and long-term management strategies.

作者信息

Mohyeldin Moiud, Norman Sarah J, Carney Ayzia, Odza Courtney

机构信息

Faculty of Medicine, UMST University, Khartoum, Sudan.

School of Medicine, American University of the Caribbean, Cupecoy, Sint Maarten.

出版信息

J Cardiothorac Surg. 2025 Jan 30;20(1):108. doi: 10.1186/s13019-025-03358-1.

Abstract

Myocardial Injury after Noncardiac Surgery (MINS) is an increasingly recognized complication that significantly impacts postoperative morbidity and mortality. Characterized by elevated cardiac troponin levels without overt ischemic symptoms, MINS presents a challenge in perioperative care. This review article explores the epidemiology, etiology, and management of MINS, with a particular focus on prevention and the latest management strategies. We discuss the role of aspirin, statins, anticoagulation, and Dual Antiplatelet Therapy (DAPT) within the context of MINS, drawing on evidence from notable clinical trials as well as observational studies. Despite advancements in understanding and managing MINS, the condition continues to be associated with high mortality and major adverse cardiovascular events (MACE), underscoring the need for ongoing research and development of more effective management protocols.

摘要

非心脏手术后心肌损伤(MINS)是一种日益受到认可的并发症,对术后发病率和死亡率有重大影响。MINS的特征是心肌肌钙蛋白水平升高但无明显缺血症状,这给围手术期护理带来了挑战。这篇综述文章探讨了MINS的流行病学、病因和管理,特别关注预防和最新的管理策略。我们在MINS的背景下讨论阿司匹林、他汀类药物、抗凝治疗和双联抗血小板治疗(DAPT)的作用,借鉴了著名临床试验以及观察性研究的证据。尽管在理解和管理MINS方面取得了进展,但该病症仍然与高死亡率和主要不良心血管事件(MACE)相关,这突出了持续研究和开发更有效管理方案的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7dc/11783716/af664b83dece/13019_2025_3358_Fig1_HTML.jpg

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