Fourth universal definition of myocardial infraction (2018)
Fourth universal definition of myocardial infraction (2018)
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DOI：
10.1016/j.gheart.2018.08.004
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发表时间：
2018-01-01
影响因子：
3.3
通讯作者：
White, Harvey D.
中科院分区：
文献类型：
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作者：
Thygesen, Kristian;Alpert, Joseph S.;White, Harvey D.
在世纪后期，尸检证实了冠状动脉血栓性闭塞与心肌梗死（MI）之间的可能关系。[1]然而，直到世纪初，才出现了第一个临床描述，描述了冠状动脉血栓形成与其相关临床特征之间的联系。2，3尽管有这些具有里程碑意义的观察结果，但在实现对该实体的普遍临床接受之前已经过了相当长的时间，部分原因是1项尸检研究显示31%的MI死亡患者的冠状动脉中没有血栓。[4]尽管最终流行使用“MI”一词，但临床上仍将其称为冠状动脉血栓形成。多年来，MI的几个不同的定义已被使用，导致争议和混乱。因此，需要一个关于MI的普遍和全球性定义。这在20世纪50 - 70年代首次发生，当时世界卫生组织（WHO）的工作组建立了一个主要基于心电图（ECG）的MI定义，旨在用于流行病学。5流行病学调查中仍使用原始描述（图1）。6-8随着更敏感的心脏生物标志物的引入，欧洲心脏病学会（ESC）和美国心脏病学会（ACC）合作使用生化和临床方法重新定义MI，并报告在急性心肌梗死背景下通过异常生物标志物检测到的心肌损伤
In the late 19th century, postmortem examinations demonstrated a possible relationship between thrombotic occlusion of a coronary artery and myocardial infarction (MI). 1 However, it was not until the beginning of the 20th century that the first clinical descriptions appeared describing a connection between the formation of a thrombus in a coronary artery and its associated clinical features. 2, 3 Despite these landmark observations, considerable time elapsed before general clinical acceptance of this entity was achieved, in part due to 1 autopsy study that showed no thrombi in the coronary arteries of 31% of deceased patients with an MI. 4 The clinical entity was referred to as coronary thrombosis, although use of the term “MI” ultimately prevailed. Over the years, several different definitions of MI have been used, leading to controversy and confusion. Hence, a general and worldwide definition for MI was needed. This occurred for the first time in the 1950–1970s, when working groups from the World Health Organization (WHO) established a primarily electrocardiographic (ECG)–based definition of MI intended for epidemiological use. 5 The original description, with minor modifications, is still used in epidemiological surveys (Figure 1). 6–8With the introduction of more sensitive cardiac biomarkers, the European Society of Cardiology (ESC) and the American College of Cardiology (ACC) collaborated to redefine MI using a biochemical and clinical approach, and reported that myocardial injury detected by abnormal biomarkers in the setting of acute myocardial