- 作者：Lotte Saaby ; Tina Svenstrup Poulsen ; Susanne Hosbond ; Torben Bjerregaard Larsen ; Axel Cosmus Pyndt Diederichsen ; Jesper Hallas ; Kristian Thygesen ; Hans Mickley
- 关键词：Troponin ; Type 2 myocardial infarction ; Universal definition of myocardial infarction
- 刊名：The American Journal of Medicine
- 出版年：2013
- 出版时间：September, 2013
- 年：2013
- 卷：126
- 期：9
- 页码：789-797
- 全文大小：318 K
Background
The classification of myocardial infarction into 5 types was introduced in 2007 as an important component of the universal definition. In contrast to the plaque rupture-related type 1 myocardial infarction, type 2 myocardial infarction is considered to be caused by an imbalance between demand and supply of oxygen in the myocardium. However, no specific criteria for type 2 myocardial infarction have been established.Methods
We prospectively studied unselected hospital patients who had cardiac troponin I measured on clinical indication. The diagnosis and classification of myocardial infarction were established, and the frequency and features of type 2 myocardial infarction were investigated by use of novel developed criteria.
Results
From January 2010 to January 2011, a total of 7230 consecutive patients who had cardiac troponin I measured were evaluated, and 4499 patients qualified for inclusion. The diagnosis of myocardial infarction was established in 553 patients, of whom 386 (72 % ) had a type 1 myocardial infarction and 144?(26 % ) had a type 2 myocardial infarction. Patients in the group with type 2 myocardial infarction were older and more likely to be female, and had more comorbidities. The proportion of patients without significant coronary artery disease was higher in those with type 2 myocardial infarction (45 % ) than in those with type 1 myocardial infarction (12 % ) (P < .001). Tachyarrhythmias, anemia, and respiratory failure were the most prevalent mechanisms causing type 2 myocardial infarction.
Conclusions
In a cohort of patients with myocardial infarction who were admitted consecutively through 1 year, the category of type 2 myocardial infarction comprised one fourth when diagnosed by the use of newly developed criteria. Approximately half of patients with type 2 myocardial infarction had no significant coronary artery disease.