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powered multicenter studies are required to better assess variation in microbial changes and its potential associations with clinical outcomes. Myocardial injury after noncardiac surgery frequently occurs and may influence survival. The aims of this study were to examine the association between myocardial injury after noncardiac surgery and patient and procedural factors as well as its impact on postoperative clinical outcome. A retrospective analysis was conducted from data collected in adults enrolled in a randomized trial in elective