TY - CHAP M1 - Book, Section TI - Myocardial Injury after Noncardiac Surgery (MINS) A1 - Cohn, Steven L. A2 - Cohn, Steven L. PY - 2021 T2 - Decision Making in Perioperative Medicine: Clinical Pearls AB - Myocardial injury is defined as an elevated troponin above the 99th percentile upper reference level and is classified into three groups: 1) acute myocardial infarction (MI) in which there is a rise and fall of troponin with at least one elevated value plus symptoms, ECG changes, or imaging suggesting an ischemic etiology; 2) acute nonischemic myocardial injury (NIMI) in which there is a similar rise and fall in troponin but no signs or symptoms of ischemia; and 3) chronic myocardial injury in which there is an elevated troponin but no rise and fall pattern. Acute MI is further defined as Type I with acute plaque rupture or Type II where there is an oxygen supply-demand mismatch. Myocardial injury after noncardiac surgery (MINS) is defined as an elevated troponin with a rise and fall pattern occurring within 30 days of surgery and presumed to be of ischemic etiology but not required to meet criteria for MI.1 Definitions vary somewhat among investigators based on troponin used, specific criteria defining an elevated value, and need for absolute change in levels.2 Troponin elevations can be seen in many conditions, both ischemic and nonischemic (Table 36-1). SN - PB - McGraw Hill CY - New York, NY Y2 - 2024/03/28 UR - accessmedicine.mhmedical.com/content.aspx?aid=1179531853 ER -