Classification of Myocardial Infarction: Frequency and Features of Type 2 Myocardial Infarction
Classification of Myocardial Infarction: Frequency and Features of Type 2 Myocardial Infarction
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DOI：
10.1016/j.amjmed.2013.02.029
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发表时间：
2013-09-01
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，作为通用定义的重要组成部分。与斑块破裂相关的1型心肌梗死相反，2型心肌梗死被认为是由心肌中氧气需求和供应之间的不平衡引起的。然而，没有具体的标准2型心肌梗死已经established.METHODS：我们前瞻性地研究了心脏肌钙蛋白I测量的临床指征的住院患者。结果：2010年1月至2011年1月，共纳入7230例连续检测心肌肌钙蛋白I的患者，4499例符合纳入标准。在553例患者中确定了心肌梗死诊断，其中386例（72%）为1型心肌梗死，144例（26%）为2型心肌梗死。2型心肌梗死组患者年龄较大，更可能是女性，并且有更多的合并症。2型心肌梗死患者中无明显冠状动脉疾病的比例（45%）高于1型心肌梗死患者（12%）（P <0.001）。快速性心律失常，贫血，呼吸衰竭是最普遍的机制，造成2型心肌infarction.CONCLUSIONS：在一个队列的心肌梗死患者连续入院1年，2型心肌梗死的类别包括四分之一时，诊断使用新开发的标准。大约一半的2型心肌梗死患者没有明显的冠状动脉疾病。(C)2013 Elsevier Inc. All rights reserved.
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. (C) 2013 Elsevier Inc. All rights reserved.