Dual Antiplatelet Therapy in Type 1 and Type 2 Myocardial Infarctions: A Systematic Review of Randomized Controlled Trials and Observational Studies

Reid, C.; AlTurki, Ahmed; Danchin, Nicolás; Yan, Andrew T.; Goodman, Shaun G.; Tanguay, Jean François; Mehta, Shilpa; Huynh, Thao

doi:10.1016/j.cjca.2016.07.087

Cited by 2 publications

(3 citation statements)

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“…The relevance of these agents for type 2 MI is uncertain and they cannot be recommended. A systematic review of 57 randomized trials evaluating dual antiplatelet therapy in 188 347 patients with ACS revealed that patients with type 2 MI were excluded from all trials . An overview of recommendations for management of AHF in patients with STEMI is shown in Table…”

Section: Pharmacologic Management Of Patients With Acute Heart Failur...mentioning

confidence: 99%

Acute coronary syndromes and acute heart failure: a diagnostic dilemma and high‐risk combination. A statement from the Acute Heart Failure Committee of the Heart Failure Association of the European Society of Cardiology

Harjola

Parissis

Bauersachs

et al. 2020

European J of Heart Fail

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Acute coronary syndrome is a precipitant of acute heart failure in a substantial proportion of cases, and the presence of both conditions is associated with a higher risk of short-term mortality compared to acute coronary syndrome alone. The diagnosis of acute coronary syndrome in the setting of acute heart failure can be challenging. Patients may present with atypical or absent chest pain, electrocardiograms can be confounded by pre-existing abnormalities, and cardiac biomarkers are frequently elevated in patients with chronic or acute heart failure, independently of acute coronary syndrome. It is important to distinguish transient or limited myocardial injury from primary myocardial infarction due to vascular events in patients presenting with acute heart failure. This paper outlines various clinical scenarios to help differentiate between these conditions and aims to provide clinicians with tools to aid in the recognition of acute coronary syndrome as a cause of acute heart failure. Interpretation of electrocardiogram and biomarker findings, and imaging techniques that may be helpful in the diagnostic work-up are described. Guidelines recommend an immediate invasive strategy for patients with acute heart failure and acute coronary syndrome, regardless of electrocardiographic or biomarker findings. Pharmacological management of patients with acute coronary syndrome and acute heart failure should follow guidelines for each of these syndromes, with priority given to time-sensitive therapies for both. Studies conducted specifically in patients with the combination of acute coronary syndrome and acute heart failure are needed to better define the management of these patients.

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Section: Pharmacologic Management Of Patients With Acute Heart Failur...mentioning

confidence: 99%

Acute coronary syndromes and acute heart failure: a diagnostic dilemma and high‐risk combination. A statement from the Acute Heart Failure Committee of the Heart Failure Association of the European Society of Cardiology

Harjola

Parissis

Bauersachs

et al. 2020

European J of Heart Fail

View full text Add to dashboard Cite

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“…5 Furthermore, there is a lack of data on the use of dual antiplatelet therapy in patients with type 2 NSTEMI from either randomized controlled trials or observational studies. 44…”

Section: Antiplatelet Therapymentioning

confidence: 99%

“…Recommendations for antiplatelet therapy are more applicable to patients with type 1 NSTEMI, as intracoronary thrombosis is absent in patients with type 2 MI . Furthermore, there is a lack of data on the use of dual antiplatelet therapy in patients with type 2 NSTEMI from either randomized controlled trials or observational studies …”

Section: Epidemiologymentioning

confidence: 99%

Defining and managing patients with non‐ST‐elevation myocardial infarction: Sorting through type 1 vs other types

Cohen

Visveswaran

2020

Clinical Cardiology

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Advances in cardiovascular (CV) imaging, redefined electrocardiogram criteria, and high‐sensitivity CV biomarker assays have enabled more differentiated etiological classification of myocardial infarction (MI). Type 1 MI has a different underlying pathophysiology than type 2 through type 5 MI; type 1 MI is characterized primarily by intracoronary atherothrombosis and the other types by a variety of mechanisms, which can occur with or without an atherosclerotic component. In type 2 MI, there is evidence of myocardial oxygen supply‐demand imbalance unrelated to acute coronary atherothrombosis. Types 1 and 2 MI are spontaneous events, while type 4 and type 5 are procedure‐related; type 3 MI is identified only after death. Most type 1 and type 2 MI present as non‐ST‐elevation MI (NSTEMI), although both types can also present as ST‐elevation MI. Because of their different underlying etiologies, type 1 and type 2 NSTEMI have different presentation and prognosis and should be managed differently. In this article, we discuss the epidemiology, prognosis, and management of NSTEMI occurring in the setting of underlying type 1 or type 2 pathophysiology. Most NSTEMI (65%–90%) are type 1 MI. Patients with type 2 MI have multiple comorbidities and causes of in‐hospital mortality among these patients are not always CV‐related. It is important to distinguish between type 1 and type 2 NSTEMI early in the clinical course to allow for the use of the most appropriate treatments that will provide the greatest benefit for these patients.

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Dual Antiplatelet Therapy in Type 1 and Type 2 Myocardial Infarctions: A Systematic Review of Randomized Controlled Trials and Observational Studies

Cited by 2 publications

References 0 publications

Acute coronary syndromes and acute heart failure: a diagnostic dilemma and high‐risk combination. A statement from the Acute Heart Failure Committee of the Heart Failure Association of the European Society of Cardiology

Acute coronary syndromes and acute heart failure: a diagnostic dilemma and high‐risk combination. A statement from the Acute Heart Failure Committee of the Heart Failure Association of the European Society of Cardiology

Defining and managing patients with non‐ST‐elevation myocardial infarction: Sorting through type 1 vs other types

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