J Cardiovasc Interv.  2025 Apr;4(2):107-119. 10.54912/jci.2024.0024.

How to Approach Patients With Elevated Cardiac Biomarkers Immediately After Noncardiac Surgery?

• Park S
• Hwang D

• KMID: 2566685
• DOI: http://doi.org/10.54912/jci.2024.0024

Abstract

Perioperative cardiac complications in noncardiac surgery (NCS) are a significant concern. Cardiac biomarker elevation after NCS presents a substantial challenge due to its tendency to manifest without typical symptoms, potentially leading to underdiagnosis. Even in the absence of clinical symptoms, cardiac biomarker elevation after NCS is associated with short- and long-term mortality. Despite advancements in medical care, identifying clinically important cardiac biomarker elevation remains difficult, emphasizing the necessity for adequate diagnostic strategies. Along with cardiovascular risk factors, surgical stress, hemodynamic instability, hypercoagulability, and inflammatory responses contribute to perioperative cardiac biomarker elevation, underscoring the requirement for a comprehensive management approach. Medical management strategies have recently shown promise in improving outcomes. However, uncertainties remain regarding routine cardiac biomarker monitoring and the medical management of this issue. Comprehensive consideration and ongoing efforts are essential to address these challenges effectively. This review provides a comprehensive discussion of elevated cardiac biomarkers after NCS, covering various aspects from incidence, clinical implications, and the mechanism of cardiac biomarker elevation after NCS to management strategies, aiming to contribute to improved clinical outcomes.

Keyword

Myocardial ischemia; Perioperative care; Biomarker; Risk factors