Peri-operative Myocardial Infarction/Injury after Peripheral Artery Disease Revascularization

The use of a serial high-sensitivity troponin assays enables the diagnosis of a peri-operative
myocardial infarction/injury (PMI), which proved to be a valuable peri-operative
prognostic marker. An absolute increase of post-operative high-sensitivity cardiac troponin
T or I in more than the upper limit of normal above the pre-operative concentration
was associated with an important increase in 30-day and long-term mortality and
cardiovascular events. In patients after revascularization, the incidence of PMI is
approximately 20% which is higher than after non-cardiac surgery in general. Only a minority
of patients with PMI after revascularization have clinical symptoms or ECG changes
suggestive of myocardial ischemia. Therefore, active surveillance is mandatory to promptly
address their residual atherosclerotic risk.