This prospective multicenter observational study aims to evaluate the predictive value of artificial intelligence-based analysis of preoperative 12-lead electrocardiography for myocardial injury after non-cardiac surgery (MINS) and major adverse cardiovascular events (MACE) within 30 days after surgery in patients undergoing non-cardiac surgery for urologic cancer.

Myocardial injury after non-cardiac surgery (MINS) is associated with increased postoperative morbidity and mortality. Patients with urologic cancer undergoing major non-cardiac surgery may be at increased risk for perioperative cardiovascular complications. Early identification of patients at high risk for postoperative myocardial injury and adverse cardiovascular events may improve perioperative risk stratification and clinical management.

This prospective multicenter observational study aims to evaluate the predictive value of artificial intelligence-based analysis of preoperative 12-lead electrocardiography for postoperative myocardial injury after non-cardiac surgery (MINS) and major adverse cardiovascular events (MACE) within 30 days after surgery in patients undergoing non-cardiac surgery for urologic cancer.

Clinical characteristics, perioperative variables, electrocardiographic data, laboratory findings, and postoperative outcomes will be prospectively collected and analyzed to identify predictors of postoperative cardiovascular complications.

Inclusion Criteria:

• Age ≥ 60 years
• Patients scheduled for major non-cardiac surgery under general anesthesia due to urologic cancer (e.g., radical prostatectomy, radical nephrectomy, partial nephrectomy)
• Patients who undergo preoperative standard 12-lead electrocardiography
• Patients classified as having intermediate or higher surgical risk
• Patients who can be followed for at least 30 days postoperatively
• Patients who voluntarily provide written informed consent to participate in this study

Exclusion Criteria:

• History of major adverse cardiovascular events (MACE) within 6 months prior to surgery
• Inability to obtain essential clinical information required for study participation and follow-up
• Patients who are not hospitalized after surgery
• Individuals deemed inappropriate for participation in the study by the investigator due to legal or psychiatric reasons

Patients aged 60 years or older scheduled for major non-cardiac surgery under general anesthesia due to urologic malignancy (e.g., radical prostatectomy, radical nephrectomy, partial nephrectomy) will be prospectively enrolled from participating centers. All eligible patients who provide informed consent and meet inclusion criteria will be followed for perioperative myocardial injury and 30-day cardiovascular outcomes.

Individual participant data will not be shared due to privacy concerns and institutional policies governing clinical data protection.