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To the Editor
We read with interest ‘Impact of cardiologist evaluation on mortality in myocardial injury after non-cardiac surgery’. Park et al 1 presented data from a retrospective study of adult patients classified as myocardial injury after non-cardiac surgery (MINS), divided into two groups based on whether evaluation by a cardiologist (consultation or transfer to the cardiology ward) occurred or not. The key finding was that patients evaluated by a cardiologist had better 30-day overall survival compared with no evaluation by a cardiologist. We are concerned that several important limitations in the methodology and conduct may have led to inappropriate conclusions. May we kindly ask the authors to provide some additional information that will help the readers to better put their findings into clinical perspective.
First, cardiac troponin (cTn) was not measured systematically in the preoperative period, thus we are concerned that in many …
Footnotes
Twitter @LopezAyalaP, @christianpuel
Collaborators Study Group of Basel-PMI: Mario Grossenbacher.
Contributors Mario Grossenbacher
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests CP reports grants from PhD Educational Platform for Health Sciences; grants from Roche Diagnostics and University Hospital Basel. CM has received research support/grants from the Swiss National Science Foundation, the Swiss Heart Foundation, the University Hospital Basel, the University of Basel, Abbott, Beckman Coulter, BRAHMS, Ortho Clinical, Quidel, Roche, Siemens and Sphingotec, as well as speaker/consulting honoraria from Acon, Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, Daiichi Sankyo, Osler, Novartis, Roche and Sanofi. All other authors have no conflict of interest to declare.
Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.
Provenance and peer review Commissioned; internally peer reviewed.
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