In this registry of consecutive patients with AMI presenting to a tertiary hospital, we studied the inter-physician reliability [weighted kappa (wK)] using the UC and the STC. Two physician investigators independently classified each patient with AMI according to the UC and STC, and a third senior physician investigator resolved any disagreement.
The study included Type 1=226 (89.7 % ), Type 2=16 (6.3 % ), Type 3=3 (1.2 % ), Type 4a=1 (0.4 % ), Type 4b=4 (1.6 % ), Type 5=2 (0.8 % ), ST-segment-elevation AMI (STEMI)=140 (55.6 % ), and non-ST-segment-elevation AMI (NSTEMI)=112 (44.4 % ). Inter-physician reliability using the UC was very good (wK=0.84, 95 % CI 0.68–0.99) and using the STC was good (wK=0.78, 95 % CI 0.70–0.86). Of patients with Type 1 AMI, 57.1 % were STEMI and 42.9 % were NSTEMI. In contrast, of patients with Type 2 AMI, 18.8 % were STEMI and 81.2 % were NSTEMI.
The UC is a reliable method to classify patients with AMI and performs better than the STC in this study. Validation of the two classifications should be performed in large prospective studies.