Perioperative Myocardial InjuryBASEL-PMINCT02573532
Incidence and Outcome of Perioperative Myocardial Injury After Non-cardiac Surgery
An observational study of Perioperative Myocardial Injury, run by University Hospital, Basel, Switzerland at 1 site in Switzerland.
Trial summary
This observational study includes patients undergoing major non-cardiac surgery, and screens them for the occurrence of perioperative myocardial injuries (PMI). Incidence, patient characteristics, pathophysiology, potential prevention and therapy strategies and 1-year outcomes of PMI will be described. Read more about this study
- Who is it for?
- Ages 45 years and older
- Conditions the study is for
- Perioperative Myocardial Injury
- How many people
- 19,645 participants
- Where
- 1 siteSwitzerland
- Study dates
- Oct 2015to Dec 2027
- Phase
- Observational
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 45 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Study population: Consecutive patients that underwent a systematic approach to PMI detection at the participating hospitals as clinical routine will be included. The screening consists of a pre-operative "baseline" measurement of hs-cTnT within 30 days prior to surgery, and two post-operative measurements taken on the first and second day after surgery. Screening is done in patients requiring hospitalization >24 hours after surgery AND (aged ≥ 65 years OR history of coronary artery disease OR peripheral artery occlusive disease OR cerebrovascular disease). Patients are seen by a cardiologist in case of detection of a PMI.
Who may be able to join
- Patients received a perioperative hs-cTnT screening for PMI
- Patient consent available Exclusion criteria
- Patient's refusal
Who cannot join
None listed.
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Switzerland1 site, 1 recruiting
- Recruiting
University Hospital Basel
Basel, Canton of Basel-City, 4031
Christian Müller, MD, Prof, +41 61 328 6549, christian.mueller@usb.ch
Christian Puelacher, MD-PhD
About this study
Official title: Basel Incidence, Patient Characteristics, Outcome and Possible Strategies to Improve Outcome of Perioperative Myocardial Injury After Non-cardiac Surgery: 1-Year Follow-up
This observational study includes patients undergoing major non-cardiac surgery, and screens them for the occurrence of perioperative myocardial injuries (PMI). Incidence, patient characteristics, pathophysiology, potential prevention and therapy strategies and 1-year outcomes of PMI will be described.
Read the detailed description
Background: Worldwide more than 230 million surgical operations are performed each year. Despite advances in all fields of medicine, there is still a significant risk of death related to major non-cardiac surgical procedures. The observed 30-day mortality depends on patient- as well as procedural factors and ranges between 1% and 10%. Cardiovascular complications, particularly perioperative myocardial injury/infarction (PMI) seem to be major contributors to about a third of all deaths. PMI may differ from spontaneous acute myocardial infarction (AMI). The vast majority of patients experiencing PMI do NOT have acute chest pain or other symptoms typical for AMI likely because they are narcotized or sedated and random ECGs are often not informative. Accordingly, most patients with PMI are currently not detected in routine clinical practice. Missed diagnosis is invariably associated with missed opportunity for the initiation of treatment. As most patients with PMI are missed in routine clinical care, the true incidence of and outcome after PMI are largely unknown. Prior studies have often not obtained a baseline sample and thus have suggested that all cTn elevations are likely due to AMI which may exaggerate the numbers. In addition, usually conventional less sensitive assays have been used. Further, the predominant pathophysiology of PMI is currently unknown. It has been suggested that type II MI characterized by coronary perfusion pressure mismatch and not type I MI characterized by acute thrombotic coronary occlusion is the predominate mechanism. However, autopsy data suggest that plaque rupture is more common. Thus, it may be that type 2 AMI is more common but that the modest incidence of type 1 AMI is not dangerous prognostically.
Aim: To explore the incidence, patient characteristics, pathophysiology, potential prevention and therapy strategies and long-term outcome of PMI after major non-cardiac surgery
Methodology: Consecutive high-risk patients undergoing major non-cardiac surgery will be included and followed for one year for the occurrence of all-cause death and other major adverse cardiac events. Patients receive a standardized assessment of cardiovascular status and systematic perioperative screening for PMI using high sensitivity cardiac troponin T (hs-cTnT) at baseline prior to surgery, as well as on day 1 and day 2 after surgery. Acute cardiac injury will be defined as an absolute increase in h/s-cTn of the 99th percentile of healthy individuals for the respective assay above baseline cTn-value or between two postoperative values if the preoperative value is missing. A search for possible alternative causes for hs-cTnT elevations will be aggressively sought if a rising pattern of values is detected. Two independent experts will adjudicate the most likely cause of PMI using all clinical information pertaining to the individual patient including the 12-lead ECG, peak hs-cTnT blood concentrations, coronary angiography and myocardial perfusion scanning. Influence of PMI on occurrence of all-cause death will be assessed using multivariate Cox-proportional hazards analysis. Further, pre-operative and post-operative prediction models for death, major adverse cardiac events, and PMI shall be derived using a derivation-validation design.
Potential Significance: This study will generate scientific data that have major scientific implications by contributing to closing current knowledge gaps concerning the influence of PMI on long-term mortality as well as the incidence, patient characteristics, and pathophysiology of PMI after non-cardiac surgery. This knowledge will have immediate clinical implications as it could e.g. lead to major changes in perioperative management with reconsiderations of the necessary target blood pressure to avoid coronary perfusion mismatch and consecutive cardiac injury.
- Conditions
- Perioperative Myocardial Injury
- Keywords
- myocardial ischemia/diagnosis, myocardial ischemia/epidemiology, perioperative, perioperative complications/diagnosis, prognosis
- Medical subject headings
- Myocardial Ischemia, Disease
What is being measured
The primary outcome is the main question the study is designed to answer.
Deaths in one year after non-cardiac surgery in patients with and without PMI
Measured: 1 year
Secondary outcomes (12)
MACE in one year after non-cardiac surgery in patients with and without PMI
MACE is defined as a composite of death, acute myocardial infarction, life-threatening arrhythmia (cardiac arrest, sustained ventricular tachycardia, atrioventricular (AV) -block III), or acute heart failure (requiring admission to a hospital or intra-hospital transfer to the intensive care unit) within one year. Two independent cardiologists or anaesthesiologists will adjudicate all MACE.
Measured: 1 year
Incidence of PMI within a screening program in high-risk patients undergoing major non-cardiac surgery
PMI is defined as an absolute increase in h/s-cTn of the 99th percentile of healthy individuals for the respective assay above baseline cTn-value or between two postoperative values if the preoperative value was missing. PMI will be further classified as type I myocardial infarction, type II myocardial infarction, or myocardial injury due to non-cardiac causes.
Measured: 3 days after surgery
Number of patients with PMI with ischemic symptoms and signs detected in a screening program in high-risk patients undergoing major non-cardiac surgery
Patients with PMI are evaluated for: presence of chest pain, atypical symptoms, palpitations, dyspnea, edema, or nausea; ST-changes, Q-waves, T-wave abnormalities, new bundle branch block
Measured: 3 days after surgery
Number of patients with PMI with management changes after screening-induced consultation
Changes in management can be: changes in medication, intensification of surveillance, call for use of coronary angiography, myocardial stress testing, other, or none
Measured: 3 days after surgery, followed for 1 year
Generate a pre- and an immediate postoperative prediction score for occurrence of major adverse cardiac events including PMI
Measured: 1 year
Costs related to the introduction of perioperative hs-cTnT screening.
Health system costs of implementation of screening is calculated as number of interventions initiated additionally to routine care after screening
Measured: 1 year
Derive and validate a risk score in patients with different subtypes of PMI for the occurrence of major cardiac adverse events to inform treatment decisions.
Endpoint: percentage of correctly classified patients in validation cohort.
Measured: 1 year
Derive and validate an improved diagnostic screening approach for detection of PMI.
Endpoint: sensitivity and specificity for PMI.
Measured: 3 days after surgery
Evaluate the effect of pre-operative medication use.
Endpoint: number of patients undergoing elective non-cardiac surgery suffering PMI (cardiac origin) after non-cardiac surgery with vs without pre-operative statin/RAAS blocker/β-blocker therapy.
Measured: 3 days after surgery
Evaluate the effect of post-PMI medication on outcome of PMI.
Endpoint: death and MACE in patients suffering PMI (cardiac origin) with vs without statin/RAAS blocker/β-blocker therapy.
Measured: 1 year
Description of PMI subtypes and potential diagnostic criteria available at time of PMI detection.
Measured: 3 days after surgery
Validate the diagnosis of PMI within a screening program in high-risk patients undergoing major non-cardiac sur-gery with other troponin assays.
PMI is defined as an absolute increase in h/s-cTn of the 99th percentile of healthy individuals for the respective assay above baseline cTn-value or between two postoperative values if the preoperative value was missing.
Measured: 3 days after surgery
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted9 Oct 2015 (estimated)
- Study startOct 2015
- Primary completionDec 2027 (estimated)
- Study completionDec 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (14)Papers the sponsor has linked to this study.
- Other trials for Perioperative Myocardial InjuryStudies of the same condition, open and under way.
- More trials run by University Hospital, Basel, SwitzerlandThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Cohort
- Time perspective
- Prospective
- Enrolment
- 19,645 participants (estimated)
Sponsor and investigators
- Lead sponsor
- University Hospital, Basel, Switzerland
- Sponsor type
- University, hospital or other
- Collaborators
- Cantonal Hospital of Aarau, Switzerland
- Responsible party
- Sponsor
- Investigators
- Christian Müller, MD, Prof, Principal investigator, University Hospital, Basel, Switzerland
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02573532
- Sponsor's protocol ID
- BASEL-PMI
- Acronym
- BASEL-PMI
- Status last verified
- Sep 2026
- First submitted
- 1 Oct 2015
- Last updated
- 28 Sep 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
Publications
Haziri F, Durak K, Glarner N, Ergin E, Burri-Winkler K, Kaplan E, Thommen V, Pargger M, Hure G, Giger RV, Bolliger D, Steiner LA, Mujagic E, Lardinois D, Scharen S, Mueller A, Kunz M, Stolte T, Mahfoud F, Strebel I, Puelacher C, Gualandro DM, Mueller C. Perioperative discontinuation of SGLT2-inhibitors and cardiac complications after noncardiac surgery: secondary analysis of two prospective observational cohort studies. Br J Anaesth. 2026 Aug;137(2):440-449. doi: 10.1016/j.bja.2026.05.004. Epub 2026 Jun 11.
PubMed 42270529Champetier A, Lopez-Ayala P, Puelacher C, Durak K, Kaplan E, Gualandro D, Glarner N, Pargger M, Hure G, Burri-Winkler K, Bolliger D, Steiner LA, Scharen S, Mujagic E, Clauss M, Mueller AM, Lardinois D, Boeddinghaus J, Mahfoud F, Strebel I, Mueller C. External validation of PreOpNet to predict 30-day mortality after major non-cardiac surgery using digital electrocardiogram. NPJ Digit Med. 2025 Oct 16;8(1):613. doi: 10.1038/s41746-025-01983-7.
PubMed 41102258Thommen V, Gualandro DM, Puelacher C, Durak K, Glarner N, Cardozo FAM, Bolliger D, Caramelli B, Mujagic E, Mueller C; BASEL-PMI Investigators. Prevalence, phenotypes, and long-term outcomes of cardiac complications after arterial vascular surgery. J Vasc Surg. 2025 Dec;82(6):2151-2160.e5. doi: 10.1016/j.jvs.2025.07.057. Epub 2025 Aug 13.
PubMed 40816634Durak K, Burri-Winkler K, Hure G, Strebel I, Reinhardt J, Thommen V, Pargger M, Glarner N, Haziri F, Seeberger E, Doyle N, Bolliger D, Steiner LA, Mujagic E, Lardinois D, Scharen S, Mueller A, Mahfoud F, Gualandro DM, Puelacher C, Mueller C. Robotic process automation to identify patients at high risk for perioperative myocardial infarction or injury: a prospective, blinded, paired reader-controlled single-centre study. Br J Anaesth. 2025 Nov;135(5):1153-1160. doi: 10.1016/j.bja.2025.07.035. Epub 2025 Jul 31.
PubMed 40750466Glarner N, Puelacher C, Gualandro DM, Pargger M, Hure G, Maiorano S, Strebel I, Fried S, Bolliger D, Steiner LA, Lampart A, Lurati Buse G, Mujagic E, Lardinois D, Kindler C, Guerke L, Schaeren S, Mueller A, Clauss M, Buser A, Hammerer-Lercher A, Mueller C; Basel-PMI Investigators. Association of preoperative beta-blocker use and cardiac complications after major noncardiac surgery: a prospective cohort study. Br J Anaesth. 2024 Jun;132(6):1194-1203. doi: 10.1016/j.bja.2024.02.023. Epub 2024 Apr 15.
PubMed 38627137Glarner N, Puelacher C, Gualandro DM, Lurati Buse G, Hidvegi R, Bolliger D, Lampart A, Burri K, Pargger M, Gerhard H, Weder S, Maiorano S, Meister R, Tschan C, Osswald S, Steiner LA, Guerke L, Kappos EA, Clauss M, Filipovic M, Arenja N, Mueller C; for the BASEL-PMI Investigators. Guideline adherence to statin therapy and association with short-term and long-term cardiac complications following noncardiac surgery: A cohort study. Eur J Anaesthesiol. 2023 Nov 1;40(11):854-864. doi: 10.1097/EJA.0000000000001903. Epub 2023 Sep 25.
PubMed 37747427Puelacher C, Gualandro DM, Glarner N, Lurati Buse G, Lampart A, Bolliger D, Steiner LA, Grossenbacher M, Burri-Winkler K, Gerhard H, Kappos EA, Clerc O, Biner L, Zivzivadze Z, Kindler C, Hammerer-Lercher A, Filipovic M, Clauss M, Gurke L, Wolff T, Mujagic E, Bilici M, Cardozo FA, Osswald S, Caramelli B, Mueller C; BASEL-PMI Investigators. Long-term outcomes of perioperative myocardial infarction/injury after non-cardiac surgery. Eur Heart J. 2023 May 14;44(19):1690-1701. doi: 10.1093/eurheartj/ehac798.
PubMed 36705050Arslani K, Gualandro DM, Puelacher C, Lurati Buse G, Lampart A, Bolliger D, Schulthess D, Glarner N, Hidvegi R, Kindler C, Blum S, Cardozo FAM, Caramelli B, Gurke L, Wolff T, Mujagic E, Schaeren S, Rikli D, Campos CA, Fahrni G, Kaufmann BA, Haaf P, Zellweger MJ, Kaiser C, Osswald S, Steiner LA, Mueller C; BASEL-PMI Investigators. Cardiovascular imaging following perioperative myocardial infarction/injury. Sci Rep. 2022 Mar 15;12(1):4447. doi: 10.1038/s41598-022-08261-6.
PubMed 35292719Lurati Buse GAL, Puelacher C, Gualandro DM, Kilinc D, Glarner N, Hidvegi R, Bolliger D, Arslani K, Lampart A, Steiner LA, Kindler C, Wolff T, Mujagic E, Guerke L, Mueller C; Incidence and Outcome of Perioperative Myocardial Injury After Non-cardiac Surgery (BASEL-PMI) Investigators. Adherence to the European Society of Cardiology/European Society of Anaesthesiology recommendations on preoperative cardiac testing and association with positive results and cardiac events: a cohort study. Br J Anaesth. 2021 Sep;127(3):376-385. doi: 10.1016/j.bja.2021.06.027. Epub 2021 Jul 28.
PubMed 34330416Sazgary L, Puelacher C, Lurati Buse G, Glarner N, Lampart A, Bolliger D, Steiner L, Gurke L, Wolff T, Mujagic E, Schaeren S, Lardinois D, Espinola J, Kindler C, Hammerer-Lercher A, Strebel I, Wildi K, Hidvegi R, Gueckel J, Hollenstein C, Breidthardt T, Rentsch K, Buser A, Gualandro DM, Mueller C; BASEL-PMI Investigators. Incidence of major adverse cardiac events following non-cardiac surgery. Eur Heart J Acute Cardiovasc Care. 2021 Jun 30;10(5):550-558. doi: 10.1093/ehjacc/zuaa008. Epub 2020 Oct 14.
PubMed 33620378Lurati Buse GAL, Puelacher C, Gualandro DM, Genini AS, Hidvegi R, Bolliger D, Arslani K, Steiner LA, Kindler C, Mueller C; BASEL-PMI Investigators. Association between self-reported functional capacity and major adverse cardiac events in patients at elevated risk undergoing noncardiac surgery: a prospective diagnostic cohort study. Br J Anaesth. 2021 Jan;126(1):102-110. doi: 10.1016/j.bja.2020.08.041. Epub 2020 Oct 17.
PubMed 33081973Puelacher C, Gualandro DM, Lurati Buse G, Bolliger D, Marbot S, Kindler C, Hammerer-Lercher A, Gurke L, Steiner L, Mueller C. Etiology of Peri-Operative Myocardial Infarction/Injury After Noncardiac Surgery and Associated Outcome. J Am Coll Cardiol. 2020 Oct 20;76(16):1910-1912. doi: 10.1016/j.jacc.2020.08.043. No abstract available.
PubMed 33059838du Fay de Lavallaz J, Puelacher C, Lurati Buse G, Bolliger D, Germanier D, Hidvegi R, Walter JE, Twerenbold R, Strebel I, Badertscher P, Sazgary L, Lampart A, Espinola J, Kindler C, Hammerer-Lercher A, Thambipillai S, Guerke L, Rentsch K, Buser A, Gualandro D, Jakob M, Mueller C; BASEL-PMI Investigators. Daytime variation of perioperative myocardial injury in non-cardiac surgery and effect on outcome. Heart. 2019 Jun;105(11):826-833. doi: 10.1136/heartjnl-2018-313876. Epub 2018 Dec 12.
PubMed 30541757Puelacher C, Lurati Buse G, Seeberger D, Sazgary L, Marbot S, Lampart A, Espinola J, Kindler C, Hammerer A, Seeberger E, Strebel I, Wildi K, Twerenbold R, du Fay de Lavallaz J, Steiner L, Gurke L, Breidthardt T, Rentsch K, Buser A, Gualandro DM, Osswald S, Mueller C; BASEL-PMI Investigators. Perioperative Myocardial Injury After Noncardiac Surgery: Incidence, Mortality, and Characterization. Circulation. 2018 Mar 20;137(12):1221-1232. doi: 10.1161/CIRCULATIONAHA.117.030114. Epub 2017 Dec 4.
PubMed 29203498
Study at a glance
From the registry record, last updated by the sponsor on 28 Sep 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Basel Incidence, Patient Characteristics, Outcome and Possible Strategies to Improve Outcome of Perioperative Myocardial Injury After Non-cardiac Surgery: 1-Year Follow-up
- ClinicalTrials.gov ID
- NCT02573532
- Acronym / sponsor ID
- BASEL-PMI / BASEL-PMI
- Conditions
- Perioperative Myocardial Injury
- Keywords
- myocardial ischemia/diagnosis, myocardial ischemia/epidemiology, perioperative, perioperative complications/diagnosis, prognosis
- Study type
- Observational
- Recruitment status
- Recruiting
- Enrolment
- 19,645 participants (estimated)
- Lead sponsor
- University Hospital, Basel, SwitzerlandUniversity, hospital or other
- Collaborators
- Cantonal Hospital of Aarau, Switzerland
- Study start
- Oct 2015 (actual)
- Primary completion
- Dec 2027 (estimated)
- Study completion
- Dec 2027 (estimated)
- First posted
- 9 Oct 2015 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This observational study includes patients undergoing major non-cardiac surgery, and screens them for the occurrence of perioperative myocardial injuries (PMI). Incidence, patient characteristics, pathophysiology, potential prevention and therapy strategies and 1-year outcomes of PMI will be described.
Detailed description
Background: Worldwide more than 230 million surgical operations are performed each year. Despite advances in all fields of medicine, there is still a significant risk of death related to major non-cardiac surgical procedures. The observed 30-day mortality depends on patient- as well as procedural factors and ranges between 1% and 10%. Cardiovascular complications, particularly perioperative myocardial injury/infarction (PMI) seem to be major contributors to about a third of all deaths. PMI may differ from spontaneous acute myocardial infarction (AMI). The vast majority of patients experiencing PMI do NOT have acute chest pain or other symptoms typical for AMI likely because they are narcotized or sedated and random ECGs are often not informative. Accordingly, most patients with PMI are currently not detected in routine clinical practice. Missed diagnosis is invariably associated with missed opportunity for the initiation of treatment. As most patients with PMI are missed in routine clinical care, the true incidence of and outcome after PMI are largely unknown. Prior studies have often not obtained a baseline sample and thus have suggested that all cTn elevations are likely due to AMI which may exaggerate the numbers. In addition, usually conventional less sensitive assays have been used. Further, the predominant pathophysiology of PMI is currently unknown. It has been suggested that type II MI characterized by coronary perfusion pressure mismatch and not type I MI characterized by acute thrombotic coronary occlusion is the predominate mechanism. However, autopsy data suggest that plaque rupture is more common. Thus, it may be that type 2 AMI is more common but that the modest incidence of type 1 AMI is not dangerous prognostically.
Aim: To explore the incidence, patient characteristics, pathophysiology, potential prevention and therapy strategies and long-term outcome of PMI after major non-cardiac surgery
Methodology: Consecutive high-risk patients undergoing major non-cardiac surgery will be included and followed for one year for the occurrence of all-cause death and other major adverse cardiac events. Patients receive a standardized assessment of cardiovascular status and systematic perioperative screening for PMI using high sensitivity cardiac troponin T (hs-cTnT) at baseline prior to surgery, as well as on day 1 and day 2 after surgery. Acute cardiac injury will be defined as an absolute increase in h/s-cTn of the 99th percentile of healthy individuals for the respective assay above baseline cTn-value or between two postoperative values if the preoperative value is missing. A search for possible alternative causes for hs-cTnT elevations will be aggressively sought if a rising pattern of values is detected. Two independent experts will adjudicate the most likely cause of PMI using all clinical information pertaining to the individual patient including the 12-lead ECG, peak hs-cTnT blood concentrations, coronary angiography and myocardial perfusion scanning. Influence of PMI on occurrence of all-cause death will be assessed using multivariate Cox-proportional hazards analysis. Further, pre-operative and post-operative prediction models for death, major adverse cardiac events, and PMI shall be derived using a derivation-validation design.
Potential Significance: This study will generate scientific data that have major scientific implications by contributing to closing current knowledge gaps concerning the influence of PMI on long-term mortality as well as the incidence, patient characteristics, and pathophysiology of PMI after non-cardiac surgery. This knowledge will have immediate clinical implications as it could e.g. lead to major changes in perioperative management with reconsiderations of the necessary target blood pressure to avoid coronary perfusion mismatch and consecutive cardiac injury.
Study design
- Observational model
- Cohort
- Time perspective
- Prospective
Who may qualify
- Ages
- 45 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
- Study population
- Consecutive patients that underwent a systematic approach to PMI detection at the participating hospitals as clinical routine will be included. The screening consists of a pre-operative "baseline" measurement of hs-cTnT within 30 days prior to surgery, and two post-operative measurements taken on the first and second day after surgery. Screening is done in patients requiring hospitalization >24 hours after surgery AND (aged ≥ 65 years OR history of coronary artery disease OR peripheral artery occlusive disease OR cerebrovascular disease). Patients are seen by a cardiologist in case of detection of a PMI.
Key inclusion criteria (3 listed)
- Patients received a perioperative hs-cTnT screening for PMI
- Patient consent available Exclusion criteria
- Patient's refusal
Key exclusion criteria (0 listed)
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Primary outcome
Deaths in one year after non-cardiac surgery in patients with and without PMI
Time frame: 1 year
12 secondary outcomes
MACE in one year after non-cardiac surgery in patients with and without PMI
Time frame: 1 year
Incidence of PMI within a screening program in high-risk patients undergoing major non-cardiac surgery
Time frame: 3 days after surgery
Number of patients with PMI with ischemic symptoms and signs detected in a screening program in high-risk patients undergoing major non-cardiac surgery
Time frame: 3 days after surgery
Number of patients with PMI with management changes after screening-induced consultation
Time frame: 3 days after surgery, followed for 1 year
Generate a pre- and an immediate postoperative prediction score for occurrence of major adverse cardiac events including PMI
Time frame: 1 year
Costs related to the introduction of perioperative hs-cTnT screening.
Time frame: 1 year
Derive and validate a risk score in patients with different subtypes of PMI for the occurrence of major cardiac adverse events to inform treatment decisions.
Time frame: 1 year
Derive and validate an improved diagnostic screening approach for detection of PMI.
Time frame: 3 days after surgery
Evaluate the effect of pre-operative medication use.
Time frame: 3 days after surgery
Evaluate the effect of post-PMI medication on outcome of PMI.
Time frame: 1 year
Description of PMI subtypes and potential diagnostic criteria available at time of PMI detection.
Time frame: 3 days after surgery
Validate the diagnosis of PMI within a screening program in high-risk patients undergoing major non-cardiac sur-gery with other troponin assays.
Time frame: 3 days after surgery
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 28 Sep 2026.
- Derived from this study: PubMed 42270529Haziri F, Durak K, Glarner N, Ergin E, Burri-Winkler K, Kaplan E, Thommen V, Pargger M, Hure G, Giger RV, Bolliger D, Steiner LA, Mujagic E, Lardinois D, Scharen S, Mueller A, Kunz M, Stolte T, Mahfoud F, Strebel I, Puelacher C, Gualandro DM, Mueller C. Perioperative discontinuation of SGLT2-inhibitors and cardiac complications after noncardiac surgery: secondary analysis of two prospective observational cohort studies. Br J Anaesth. 2026 Aug;137(2):440-449. doi: 10.1016/j.bja.2026.05.004. Epub 2026 Jun 11.
- Derived from this study: PubMed 41102258Champetier A, Lopez-Ayala P, Puelacher C, Durak K, Kaplan E, Gualandro D, Glarner N, Pargger M, Hure G, Burri-Winkler K, Bolliger D, Steiner LA, Scharen S, Mujagic E, Clauss M, Mueller AM, Lardinois D, Boeddinghaus J, Mahfoud F, Strebel I, Mueller C. External validation of PreOpNet to predict 30-day mortality after major non-cardiac surgery using digital electrocardiogram. NPJ Digit Med. 2025 Oct 16;8(1):613. doi: 10.1038/s41746-025-01983-7.
- Derived from this study: PubMed 40816634Thommen V, Gualandro DM, Puelacher C, Durak K, Glarner N, Cardozo FAM, Bolliger D, Caramelli B, Mujagic E, Mueller C; BASEL-PMI Investigators. Prevalence, phenotypes, and long-term outcomes of cardiac complications after arterial vascular surgery. J Vasc Surg. 2025 Dec;82(6):2151-2160.e5. doi: 10.1016/j.jvs.2025.07.057. Epub 2025 Aug 13.
- Derived from this study: PubMed 40750466Durak K, Burri-Winkler K, Hure G, Strebel I, Reinhardt J, Thommen V, Pargger M, Glarner N, Haziri F, Seeberger E, Doyle N, Bolliger D, Steiner LA, Mujagic E, Lardinois D, Scharen S, Mueller A, Mahfoud F, Gualandro DM, Puelacher C, Mueller C. Robotic process automation to identify patients at high risk for perioperative myocardial infarction or injury: a prospective, blinded, paired reader-controlled single-centre study. Br J Anaesth. 2025 Nov;135(5):1153-1160. doi: 10.1016/j.bja.2025.07.035. Epub 2025 Jul 31.
- Derived from this study: PubMed 38627137Glarner N, Puelacher C, Gualandro DM, Pargger M, Hure G, Maiorano S, Strebel I, Fried S, Bolliger D, Steiner LA, Lampart A, Lurati Buse G, Mujagic E, Lardinois D, Kindler C, Guerke L, Schaeren S, Mueller A, Clauss M, Buser A, Hammerer-Lercher A, Mueller C; Basel-PMI Investigators. Association of preoperative beta-blocker use and cardiac complications after major noncardiac surgery: a prospective cohort study. Br J Anaesth. 2024 Jun;132(6):1194-1203. doi: 10.1016/j.bja.2024.02.023. Epub 2024 Apr 15.
- Derived from this study: PubMed 37747427Glarner N, Puelacher C, Gualandro DM, Lurati Buse G, Hidvegi R, Bolliger D, Lampart A, Burri K, Pargger M, Gerhard H, Weder S, Maiorano S, Meister R, Tschan C, Osswald S, Steiner LA, Guerke L, Kappos EA, Clauss M, Filipovic M, Arenja N, Mueller C; for the BASEL-PMI Investigators. Guideline adherence to statin therapy and association with short-term and long-term cardiac complications following noncardiac surgery: A cohort study. Eur J Anaesthesiol. 2023 Nov 1;40(11):854-864. doi: 10.1097/EJA.0000000000001903. Epub 2023 Sep 25.
- Derived from this study: PubMed 36705050Puelacher C, Gualandro DM, Glarner N, Lurati Buse G, Lampart A, Bolliger D, Steiner LA, Grossenbacher M, Burri-Winkler K, Gerhard H, Kappos EA, Clerc O, Biner L, Zivzivadze Z, Kindler C, Hammerer-Lercher A, Filipovic M, Clauss M, Gurke L, Wolff T, Mujagic E, Bilici M, Cardozo FA, Osswald S, Caramelli B, Mueller C; BASEL-PMI Investigators. Long-term outcomes of perioperative myocardial infarction/injury after non-cardiac surgery. Eur Heart J. 2023 May 14;44(19):1690-1701. doi: 10.1093/eurheartj/ehac798.
- Derived from this study: PubMed 35292719Arslani K, Gualandro DM, Puelacher C, Lurati Buse G, Lampart A, Bolliger D, Schulthess D, Glarner N, Hidvegi R, Kindler C, Blum S, Cardozo FAM, Caramelli B, Gurke L, Wolff T, Mujagic E, Schaeren S, Rikli D, Campos CA, Fahrni G, Kaufmann BA, Haaf P, Zellweger MJ, Kaiser C, Osswald S, Steiner LA, Mueller C; BASEL-PMI Investigators. Cardiovascular imaging following perioperative myocardial infarction/injury. Sci Rep. 2022 Mar 15;12(1):4447. doi: 10.1038/s41598-022-08261-6.
- Derived from this study: PubMed 34330416Lurati Buse GAL, Puelacher C, Gualandro DM, Kilinc D, Glarner N, Hidvegi R, Bolliger D, Arslani K, Lampart A, Steiner LA, Kindler C, Wolff T, Mujagic E, Guerke L, Mueller C; Incidence and Outcome of Perioperative Myocardial Injury After Non-cardiac Surgery (BASEL-PMI) Investigators. Adherence to the European Society of Cardiology/European Society of Anaesthesiology recommendations on preoperative cardiac testing and association with positive results and cardiac events: a cohort study. Br J Anaesth. 2021 Sep;127(3):376-385. doi: 10.1016/j.bja.2021.06.027. Epub 2021 Jul 28.
- Derived from this study: PubMed 33620378Sazgary L, Puelacher C, Lurati Buse G, Glarner N, Lampart A, Bolliger D, Steiner L, Gurke L, Wolff T, Mujagic E, Schaeren S, Lardinois D, Espinola J, Kindler C, Hammerer-Lercher A, Strebel I, Wildi K, Hidvegi R, Gueckel J, Hollenstein C, Breidthardt T, Rentsch K, Buser A, Gualandro DM, Mueller C; BASEL-PMI Investigators. Incidence of major adverse cardiac events following non-cardiac surgery. Eur Heart J Acute Cardiovasc Care. 2021 Jun 30;10(5):550-558. doi: 10.1093/ehjacc/zuaa008. Epub 2020 Oct 14.
- Derived from this study: PubMed 33081973Lurati Buse GAL, Puelacher C, Gualandro DM, Genini AS, Hidvegi R, Bolliger D, Arslani K, Steiner LA, Kindler C, Mueller C; BASEL-PMI Investigators. Association between self-reported functional capacity and major adverse cardiac events in patients at elevated risk undergoing noncardiac surgery: a prospective diagnostic cohort study. Br J Anaesth. 2021 Jan;126(1):102-110. doi: 10.1016/j.bja.2020.08.041. Epub 2020 Oct 17.
- Derived from this study: PubMed 33059838Puelacher C, Gualandro DM, Lurati Buse G, Bolliger D, Marbot S, Kindler C, Hammerer-Lercher A, Gurke L, Steiner L, Mueller C. Etiology of Peri-Operative Myocardial Infarction/Injury After Noncardiac Surgery and Associated Outcome. J Am Coll Cardiol. 2020 Oct 20;76(16):1910-1912. doi: 10.1016/j.jacc.2020.08.043. No abstract available.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Christian Müller, MD, Prof principal investigator
University Hospital, Basel, Switzerland
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Perioperative Myocardial Injury, run by University Hospital, Basel, Switzerland at 1 site in Switzerland.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 3 inclusion and 0 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: looking for participants now, as of the sponsor's last update on 28 Sep 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Switzerland. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Christian Müller, MD, Prof (+41 61 328 6549, christian.mueller@usb.ch), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Deaths in one year after non-cardiac surgery in patients with and without PMI (time frame: 1 year). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT02573532, which also lists 14 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 28 Sep 2026.