Clinical research studyClassification of Myocardial Infarction: Frequency and Features of Type 2 Myocardial Infarction
Section snippets
Study Design and Population
The study comprises patients consecutively admitted to a 1000-bed university hospital, which serves as a tertiary referral center for a region with 1.2 million inhabitants and as a local hospital for a catchment area of 300,000 residents. The data is a part of the DEF-AMI Study (Consequences of the universal 2007 DEFinition of Acute Myocardial Infarction studied in a Danish consecutive hospital population). All admitted patients who had cardiac troponin I (cTnI) measured were traced through
Results
cTnI was measured in 7230 hospitalized patients admitted between January 6, 2010, and January 5, 2011. Approximately one third of patients did not meet the inclusion criteria. Thus, 4499 patients were enrolled, and of these 1961 had cTnI elevation above the 99th percentile upper reference limit. Figure 1 shows that 553 patients (12.3%) had myocardial infarction.
Discussion
In this study, 4499 consecutive hospitalized patients with a suspected acute myocardial infarction were evaluated according to the principles of the universal definition and with particular emphasis on novel clinical standard criteria for the classification of type 2 myocardial infarction. Thus, 553 patients had acute myocardial infarction, of whom 26% were classified as having type 2 myocardial infarction. Approximately half of patients with type 2 myocardial infarction did not have
Conclusions
This prospective study on the classification and features of patients with myocardial infarction defined according to the universal definition demonstrates that 26% of these patients had type 2 myocardial infarction when novel developed clinical criteria were used. Patients with type 2 myocardial infarction generally had more severe clinical characteristics than patients with type 1 myocardial infarction. Approximately half of patients with type 2 myocardial infarction had no significant
Acknowledgments
The authors thank Jens Lauritsen, MD, PhD, for taking care of the database.
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Funding: This study has been financially supported by the Danish Heart Association, Odense University Hospital, Denmark and by the University of Southern Denmark, Odense, Faculty of Health Sciences.
Conflict of Interest: None.
Authorship: All authors had access to the data and played a role in writing this manuscript.