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@article{1398069,
author = {Nestelberger, T. and Boeddinghaus, J. and Badertscher, P. and Twerenbold, R. and Wildi, K. and Breitenbucher, D. and Sabti, Z. and Puelacher, C. and Gimenez, M.R. and Kozhuharov, N. and Strebel, I. and Sazgary, L. and Schneider, D. and Jann, J. and du Fay de Lavallaz, J. and Miro, O. and MartinandSanchez, F.J. and Morawiec, B. and Kawecki, D. and Muzyk, P. and Keller, D.I. and Geigy, N. and Osswald, S. and Reichlin, T. and Mueller, C. and Pařenica, Jiří},
article_location = {USA},
article_number = {13},
doi = {http://dx.doi.org/10.1016/j.jacc.2017.07.774},
keywords = {diagnosis; high-sensitivity cardiac troponin; type 2 myocardial infarction},
language = {eng},
issn = {0735-1097},
journal = {Journal of The American College of Cardiology},
title = {Effect of Definition on Incidence and Prognosis of Type 2 Myocardial Infarction},
url = {http://dx.doi.org/10.1016/j.jacc.2017.07.774},
volume = {70},
year = {2017}
}
TY - JOUR
ID - 1398069
AU - Nestelberger, T. - Boeddinghaus, J. - Badertscher, P. - Twerenbold, R. - Wildi, K. - Breitenbucher, D. - Sabti, Z. - Puelacher, C. - Gimenez, M.R. - Kozhuharov, N. - Strebel, I. - Sazgary, L. - Schneider, D. - Jann, J. - du Fay de Lavallaz, J. - Miro, O. - Martin-Sanchez, F.J. - Morawiec, B. - Kawecki, D. - Muzyk, P. - Keller, D.I. - Geigy, N. - Osswald, S. - Reichlin, T. - Mueller, C. - Pařenica, Jiří
PY - 2017
TI - Effect of Definition on Incidence and Prognosis of Type 2 Myocardial Infarction
JF - Journal of The American College of Cardiology
VL - 70
IS - 13
SP - 1558-1568
EP - 1558-1568
PB - Elsevier Science Inc.
SN - 07351097
KW - diagnosis
KW - high-sensitivity cardiac troponin
KW - type 2 myocardial infarction
UR - http://dx.doi.org/10.1016/j.jacc.2017.07.774
L2 - http://dx.doi.org/10.1016/j.jacc.2017.07.774
N2 - 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.
ER -
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. Effect of Definition on Incidence and Prognosis of Type 2 Myocardial Infarction. \textit{Journal of The American College of Cardiology}. USA: Elsevier Science Inc., roč.~70, č.~13, s.~1558-1568. ISSN~0735-1097. doi:10.1016/j.jacc.2017.07.774. 2017.
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