J 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.

Basic information

Original name

Effect of Definition on Incidence and Prognosis of Type 2 Myocardial Infarction

Authors

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 and C. MUELLER

Edition

Journal of The American College of Cardiology, USA, Elsevier Science Inc. 2017, 0735-1097

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30201 Cardiac and Cardiovascular systems

Country of publisher

United States of America

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

Impact factor

Impact factor: 16.834

Organization unit

Faculty of Medicine

UT WoS

000410985400003

Keywords in English

diagnosis; high-sensitivity cardiac troponin; type 2 myocardial infarction

Tags

Tags

International impact, Reviewed
Změněno: 5/12/2017 13:14, Soňa Böhmová

Abstract

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.