2017
Effect of Definition on Incidence and Prognosis of Type 2 Myocardial Infarction
NESTELBERGER, T.; J. BOEDDINGHAUS; P. BADERTSCHER; R. TWERENBOLD; K. WILDI et. al.Základní údaje
Originální název
Effect of Definition on Incidence and Prognosis of Type 2 Myocardial Infarction
Autoři
NESTELBERGER, T.; J. BOEDDINGHAUS; P. BADERTSCHER; R. TWERENBOLD; K. WILDI; D. BREITENBUCHER; Z. SABTI; C. PUELACHER; M.R. GIMENEZ; N. KOZHUHAROV; I. STREBEL; L. SAZGARY; D. SCHNEIDER; J. JANN; J. DU FAY DE LAVALLAZ; O. MIRO; F.J. MARTIN-SANCHEZ; B. MORAWIEC; D. KAWECKI; P. MUZYK; D.I. KELLER; N. GEIGY; S. OSSWALD; T. REICHLIN a C. MUELLER
Vydání
Journal of The American College of Cardiology, USA, Elsevier Science Inc. 2017, 0735-1097
Další údaje
Jazyk
angličtina
Typ výsledku
Článek v odborném periodiku
Obor
30201 Cardiac and Cardiovascular systems
Stát vydavatele
Spojené státy
Utajení
není předmětem státního či obchodního tajemství
Odkazy
Impakt faktor
Impact factor: 16.834
Organizační jednotka
Lékařská fakulta
UT WoS
000410985400003
Klíčová slova anglicky
diagnosis; high-sensitivity cardiac troponin; type 2 myocardial infarction
Štítky
Příznaky
Mezinárodní význam, Recenzováno
Změněno: 5. 12. 2017 13:14, Soňa Böhmová
Anotace
V originále
BACKGROUND Uncertainties regarding the most appropriate definition and treatment of type 2 myocardial infarction (T2MI) due to supply-demand mismatch have contributed to inconsistent adoption in clinical practice. OBJECTIVES This study sought a better understanding of the effect of the definition of T2MI on its incidence, treatment, and event-related mortality, thereby addressing an important unmet clinical need. METHODS The final diagnosis was adjudicated in patients presenting with symptoms suggestive of myocardial infarction by 2 independent cardiologists by 2 methods: 1 method required the presence of coronary artery disease, a common interpretation of the 2007 universal definition (T2MI(2007)); and 1 method did not require coronary artery disease, the 2012 universal definition (T2MI(2012)). RESULTS Overall, 4,015 consecutive patients were adjudicated. The incidence of T2MI based on the T2MI(2007) definition was 2.8% (n = 112). The application of the more liberal T2MI(2012) definition resulted in an increase of T2MI incidence of 6% (n = 240), a relative increase of 114% (128 reclassified patients, defined as T2MI(2012reclassified)). Among T2MI(2007), 6.3% of patients received coronary revascularization, 22% dual-antiplatelet therapy, and 71% high-dose statin therapy versus 0.8%, 1.6%, and 31% among T2MI(2012reclassified) patients, respectively (all p < 0.01). Cardiovascular mortality at 90 days was 0% among T2MI(2012reclassified), which was similar to patients with noncardiac causes of chest discomfort (0.2%), and lower than T2MI(2007) (3.6%) and type 1 myocardial infarction (T1MI) (4.8%) (T2MI(2012reclassified) vs. T2MI(2007) and T1MI: p = 0.03 and 0.01, respectively). CONCLUSIONS T2MI(2012reclassified) has a substantially lower event-related mortality rate compared with T2MI(2007) and T1MI. (Advantageous Predictors of Acute Coronary Syndromes Evaluation [APACE] Study; NCT00470587) (C) 2017 by the American College of Cardiology Foundation.