RT Journal Article SR Electronic T1 Impact of clinical diagnosis of myocardial infarction in patients with elevated cardiac troponin JF Heart JO Heart FD BMJ Publishing Group Ltd and British Cardiovascular Society SP 1533 OP 1541 DO 10.1136/heartjnl-2022-322298 VO 109 IS 20 A1 Gard, Anton A1 Lindahl, Bertil A1 Baron, Tomasz YR 2023 UL http://heart.bmj.com/content/109/20/1533.abstract AB Objective Type 2 myocardial infarction (MI) and myocardial injury are common conditions associated with an adverse prognosis. Physicians experience uncertainty how to distinguish these conditions, as well as how to manage and treat them. Therefore, the objective of this study was to compare treatment and prognosis in patients with an adjudicated diagnosis of type 2 MI and myocardial injury, who were discharged with and without a clinical diagnosis of MI.Design The study consisted of two cohorts, 964 and 281 consecutive patients with elevated cardiac troponin, discharged with and without a clinical diagnosis of MI, respectively. All cases were adjudicated into MI type 1–5 or myocardial injury and followed regarding all-cause death.Results The adjudication identified 138 and 37 cases of type 2 MI, and 86 and 185 of myocardial injury, with and without a clinical MI diagnosis, respectively. In patients with type 2 MI, a clinical MI diagnosis was associated with more coronary angiography investigations (39.1% vs 5.4%, p<0.001) and an increased use of secondary prevention medications (all p<0.001). However, no difference was observed in adjusted 5-year mortality between patients with and without a clinical MI diagnosis (HR: 0.77 with 95% CI 0.43 to 1.38). The results were similar for adjudicated myocardial injury.Conclusion In both type 2 MI and myocardial injury, a clinical diagnosis of MI at discharge was associated with more investigations and treatments. However, no prognostic effect of receiving a clinical MI diagnosis was observed.Data are available upon reasonable request. Due to Swedish laws on personal integrity and health data, as well as the Ethics Committee, we are not allowed to make any data including health variables open to the public even if made anonymous. The data could be shared with other researchers after a request to the head of our department (es.uu.icsdem@grebdnil.ave).