We read with great interest the article by Yang et al. who reported the important association of myocardial injury after non-cardiac surgery (MINS) and major adverse cardiac events . Importantly, MINS was defined as a. an elevated troponin judged to result from myocardial ischemia; b. lack of evidence of a non-ischemic etiology; and c. presence of ischemic clinical features is not required but permitted . We congratulate the authors on this novel and important finding, and would like to highlight several points. First, the authors do not state how a non-ischemic etiology was excluded. In practice, the dominant post liver transplant cardiomyopathy is of a non-ischemic etiology; it is usually associated with elevated troponin; and reportedly occurs with incidence as high as 14% . Yet, of a cohort of 519 recipients, 284 thereof liver transplant, 112 patients had troponin drawn, but not a single elevated troponin was ascribed to a non-ischemic etiology (Fig. 1) [ ]. Second, the preoperative cardiac workup is not delineated, the model of end-stage liver disease (“MELD”) score, the most important pretransplant survival marker, as well as the kidney donor risk index are not provided, despite the predictive value of the latter indices on post-transplant outcomes. Third, intraoperative hemorrhage and use of vasopressor/inotrope are not stated, in spite of their critical role in supply-demand ischemia . Lastly, the proportion of MINS occurring in absence of any ischemic features (i.e., isolated troponinemia) is not reported, its prognostic significance, therefore, remains unexplored, and the indication for drawing troponin in this clinical scenario is unclear.