EDITORIAL

Myocardial infarction: redefined or reinvented?

H Dargie

Correspondence to:
Correspondence to:
Professor Henry J Dargie, Guidelines and Medical Practice Committee, British Cardiac Society, London, UK;
h.dargie@bio.gla.ac.uk

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Troponins have recently been promoted to playing a pivotal role in the diagnosis of acute myocardial infarction. However, a number of problems arise as a result of this "redefinition" of acute MI

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Keywords: myocardial infarction; troponins

Abbreviations: ACC, American College of Cardiology; CK, creatine kinase; ESC, European Society of Cardiology; STEMI, ST segment elevation myocardial infarction

The recent joint statement by the European Society of Cardiology (ESC) and the American College of Cardiology (ACC) proposing a "redefinition" of myocardial infarction has aroused much interest but also sparked considerable controversy.¹ The basis of the new definition is the promotion of troponins to a pivotal role in the diagnosis of acute myocardial infarction, coupled with the relegation of creatine kinase (CK-MB) to a secondary role; and, in the case of total CK, to the realms of history.

Elevation of troponins to centre stage in the drama of acute myocardial infarction is a direct consequence of the recent emergence of new terminology for acute coronary disease. Thus the term "acute coronary syndromes", coined to describe unstable angina and non-Q wave myocardial infarction, now also includes acute Q wave myocardial infarction. This has stimulated the formulation of management strategies based, at the time of presentation, on the ECG and, subsequently, . . . [Full text of this article]

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Redefining myocardial infarction

John S Birkhead

Online, 4 Jul 2002 [Full text]