A new study published in the European heart Journal indicates that a simple intervention-a cardiology consultation-may considerably improve outcomes for patients experiencing heart injury during or after non-cardiac surgery. researchers found that patients who received a cardiology evaluation had a 35% lower risk of morta
A new observational study suggests that a cardiology consultation following heart injury during or after non-cardiac surgery is linked to a 35% reduction in mortality and a 46% decrease in major cardiovascular events within the first year post-surgery. This research highlights the importance of specialized cardiac care for patients undergoing non-heart-related procedures, particularly those at higher risk.
Researchers at the University of Basel in Switzerland have published findings indicating a significant clinical impact from addressing a frequently overlooked, yet potentially dangerous, complication. The investigation, published in the European Heart Journal, focused on perioperative myocardial injury (PMI), a common and often symptomless event that occurs during or after non-cardiac surgeries, and is a strong predictor of future complications.
The research team, led by Professor Christian Müller and spearheaded by Drs. Christian Puelacher and Noemi Glarner, followed 1048 patients who experienced PMI after procedures such as orthopedic surgeries. These patients were considered high-risk due to being over 65 years old or having pre-existing cardiovascular disease and were treated in surgical wards. A practical circumstance influenced the study’s analysis: only 614 patients (58.6%) received a formal evaluation by a cardiologist during their hospital stay. The remaining 434 (41.4%) did not see a cardiologist, often due to logistical challenges like weekends or holidays, or because more urgent cases took priority.
After adjusting for multiple confounding factors, the results revealed a notable association. Patients who were evaluated by a cardiologist had a 35% lower probability of death in the year following surgery. Additionally, the risk of experiencing a major cardiovascular event – such as a new heart attack, heart failure, severe arrhythmia, or cardiovascular-related death – was 46% lower. Dr. Christian Puelacher explained that the stress of surgery, including anesthesia, blood loss, and blood pressure changes, puts a strain on the heart. “In high-risk patients, PMI occurs in approximately 15% of cases, usually without any symptoms,” he stated.
The analysis also showed that the group seen by a cardiologist underwent more cardiac imaging tests and were more frequently prescribed medications specific to their cardiovascular condition. “Our study shows that having a cardiologist involved in care after a PMI is associated with fewer serious heart problems and better survival one year later,” Puelacher summarized, emphasizing the importance of “close collaboration between surgical and cardiac teams.”
Dr. Noemi Glarner offered a crucial caveat regarding the nature of the work. “This is an observational study, which cannot prove a cause-and-effect relationship, even with strong adjustments for other factors. As the gold standard, a randomized controlled trial is needed to definitively confirm the results.” The team is now conducting a study to implement systematic PMI screening in hospitals in Switzerland and Austria.
In an accompanying editorial, Professor William Weintraub of Georgetown University deemed the study “valuable” and addressing an important and “potentially modifiable” management issue. Weintraub and his colleague praised the rigorous conduct of the research but also cautioned against completely excluding the influence of unmeasured variables. Despite the limitations, they found the evidence pointed toward a clinical benefit. “It is highly likely that all stakeholders, including healthcare professionals, health systems, and, especially, patients, would favor a structured cardiology consultation in this context,” they concluded.
Bibliographic Reference:
Puelacher, C., Glarner, N., et al. (2026). Cardiology consultation and long-term clinical outcomes after perioperative myocardial infarction/injury. European Heart Journal. https://doi.org/10.1093/eurheartj/ehae001.
Weintraub, W., & Alexander, K. (2026). Editorial: Cardiology consultation after perioperative myocardial infarction/injury: Is it time? European Heart Journal. https://doi.org/10.1093/eurheartj/ehae002.
NR/HN/AlphaGalileo
Other articles of interest:
