title: Detection and management of perioperative myocardial ischemia.
abstract: OBJECTIVE
  To review the current evidence for detection and management of perioperative myocardial ischemia.
  
  
  RESULTS
  Patients who sustain a myocardial injury after noncardiac surgery are predominantly asymptomatic. Myocardial injury after noncardiac surgery is associated with both short-term and long-term mortality. Mortality from both cardiac and noncardiac causes is significant.
  
  
  CONCLUSIONS
  Perioperative physicians should refrain from the use of nonsurgical diagnostic criteria for myocardial infarction and adopt the clinical entity known as myocardial injury after noncardiac surgery in order to allow for better determination of the prevalence of this perioperative complication. Studies should focus on establishing the feasibility of broad postoperative troponin surveillance following noncardiac surgery. Clinical trials of potential therapies for myocardial injury after noncardiac surgery are urgently needed.
authors.affiliation: Perioperative Research Group, Department of Anaesthetics, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa.
authors.forename: Bruce M
authors.initials: BM
authors.lastname: Biccard
mesh_terms: D015415:Biomarkers; D006801:Humans; D017202:Myocardial Ischemia / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D019990:Perioperative Care / Q000379:methods*; D011183:Postoperative Complications / Q000628:therapy; D014336:Troponin / Q000097:blood
chemical_list: D015415:Biomarkers; D014336:Troponin