Myocardial injury in oncology patients undergoing noncardiac surgery for MRONJ: risk factors and nutritional associations.

PURPOSE: To investigate the incidence and risk factors of myocardial injury after noncardiac surgery (MINS) in oncology patients undergoing surgery for medication-related osteonecrosis of the Jaw (MRONJ). METHODS: This retrospective study analyzed 65 patients with oncology-related MRONJ who underwent surgical treatment between October 2024 and May 2025. High-sensitivity cardiac troponin I (hs-cTn I) levels were measured preoperatively and within 72 h postoperatively. MINS was diagnosed according to established criteria. Clinical characteristics were compared and analyzed between patients with and without MINS to evaluate associations among relevant variables. RESULTS: Among the 65 patients, 7 (10.8%) developed MINS. Compared with patients without MINS, those with MINS had a significantly lower body mass index (BMI; P = 0.003), a higher prevalence of preoperative myocardial injury (P = 0.005), lower preoperative serum albumin levels (P = 0.039), and a significantly more severe anemia (P = 0.029). Spearman correlation analysis demonstrated a moderate positive correlation between MINS and preoperative myocardial injury (ρ = 0.435, P < 0.001) and a negative correlation between MINS and BMI (ρ = - 0.366, P = 0.003). Significant correlations were also observed among BMI, serum albumin levels, and anemia severity, suggesting an interaction between nutritional status and postoperative myocardial injury in MRONJ patients. CONCLUSION: In this exploratory study, MINS in oncology-related MRONJ patients was observed to be associated with preoperative myocardial injury, low BMI, hypoalbuminemia, and anemia. These preliminary findings suggest that incorporating nutritional assessment and cardiac biomarker surveillance into perioperative evaluation may support risk stratification. However, these observed associations require confirmation in larger, prospective studies.