cTnI increases are encountered in approximately a third of patients, the majority due to nonatherothrombotic conditions. Compared with patients without myonecrosis, type 2 myocardial infarction and myocardial injury have worse short-term outcomes, with mortality rates >20% at 2 years. hs-cTnI assay does not lead to more myocardial injury or infarction.
ICD-9-coded MIs captured only a small proportion of adjudicated MIs, primarily from not coding T2MI. Our findings emphasize the need for an ICD code for T2MI.
hs-cTnI and contemporary cTnI assays are excellent in ruling out MI following recommendations predicated on serial testing and the 99th percentile with a normal ECG. For ruling in MI, deltas improve the specificity. ClinicalTrials.gov Identifier: NCT02060760.
The article reports the case of a 39-year-old male who was diagnosed with and treated for bipolar disorder. Over the past 18 months, the patient has experienced new onset of auditory hallucinations and worsening of his psychotic symptoms. The treating psychiatrists changed the diagnosis from bipolar disorder to schizoaffective disorder. The authors discuss hierarchical and nonhierarchical approaches to psychiatric diagnosis in relation to this case report. (Journal of Psychiatric Practice 2003;9:324-327)
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