Mortality Rate in Type 2 Myocardial Infarction: Observations from an Unselected Hospital Cohort
Mortality Rate in Type 2 Myocardial Infarction: Observations from an Unselected Hospital Cohort
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DOI：
10.1016/j.amjmed.2013.12.020
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发表时间：
2014-04-01
影响因子：
5.9
通讯作者：
Mickley, Hans
中科院分区：
文献类型：
--
作者：
Saaby, Lotte;Poulsen, Tina Svenstrup;Mickley, Hans
背景：2007年引入了心肌梗死5型分类。这个普遍的定义，特别是对2型心肌梗死的预后影响，还没有进行前瞻性研究，在cardiac hospital patients.METHODS：在1年的时间内，所有住院患者的心肌肌钙蛋白I测量被认为是。根据通用定义诊断心肌梗死，并在2型心肌梗死的分类中使用特定标准。随访至少1年，死亡率为endpoint.Results：共3762例连续患者进行了研究，其中488（13%）有心肌梗死。119例患者诊断为2型心肌梗死。在中位数2.1年（四分位距，1.6-2.5年）后，150例患者死亡，2型心肌梗死患者的死亡率为49%（58/119），1型心肌梗死患者的死亡率为26%（92/360）（P <0.0001）。在多变量考克斯回归分析中，以下变量与死亡率独立相关：当前或既往吸烟者、高龄、既往心肌梗死、2型心肌梗死、高胆固醇血症、高p-肌酐和糖尿病。2型心肌梗死的多变量校正风险比为2.0（95%置信区间，1.3-3.0）。休克作为唯一的例外，死亡率是独立的触发条件导致2型myocardial infarction.CONCLUSIONS：2型心肌梗死患者的死亡率很高，2年后达到约50%。需要进一步的描述性和生存率研究来改善2型心肌梗死治疗所依据的科学证据。(C)2014爱思唯尔公司All rights reserved.
BACKGROUND: The classification of myocardial infarction into 5 types was introduced in 2007. The prognostic impact of this universal definition, with particular focus on type 2 myocardial infarction, has not been studied prospectively in unselected hospital patients.METHODS: During a 1-year period, all hospitalized patients having cardiac troponin I measured were considered. The diagnosis of a myocardial infarction was according to the universal definition, and specified criteria were used in the classification of type 2 myocardial infarction. Follow-up was at least 1 year, with mortality as the end point.RESULTS: A total of 3762 consecutive patients were studied, of whom 488 (13%) had a myocardial infarction. In 119 patients a type 2 myocardial infarction was diagnosed. After a median of 2.1 years (interquartile range, 1.6-2.5 years), 150 patients had died, with a mortality rate of 49% (58/119) in those with type 2 myocardial infarction and 26% (92/360) in those with type 1 myocardial infarction (P < .0001). In a multivariable Cox regression analysis the following variables were independently associated with mortality: current or prior smoker, high age, prior myocardial infarction, type 2 myocardial infarction, hypercholesterolemia, high p-creatinine, and diabetes mellitus. The multivariable-adjusted hazard ratio for type 2 myocardial infarction was 2.0 (95% confidence interval, 1.3-3.0). With shock as the only exception, mortality was independent of the triggering conditions leading to type 2 myocardial infarction.CONCLUSIONS: Mortality in patients with type 2 myocardial infarction is high, reaching approximately 50% after 2 years. Further descriptive and survival studies are needed to improve the scientific evidence on which treatment of type 2 myocardial infarction is based. (C) 2014 Elsevier Inc. All rights reserved.