Fourth universal definition of myocardial infarction. Selected messages from the European Society of Cardiology document and lessons learned from the new guidelines on ST-segment elevation myocardial infarction and non-ST-segment elevation-acute coronary syndrome

Domienik‐Karłowicz, Justyna; Kupczyńska, Karolina; Michalski, Błażej; Kapłon‐Cieślicka, Agnieszka; Darocha, Szymon; Dobrowolski, Piotr; Wybraniec, Maciej T.; Wańha, Wojciech; Jaguszewski, Miłosz

doi:10.5603/cj.a2021.0036

Cited by 36 publications

(22 citation statements)

References 27 publications

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“…Cardiovascular death was de ned as any death secondary to AMI, HF, sudden cardiac death, stroke, cardiovascular procedure, cardiovascular hemorrhage or other cardiovascular causes. AMI was de ned according to the fourth de nition of AMI (24). HF events included any emergency department visit or hospitalization for HF as well as any urgent or unscheduled outpatient o ce visits with a primary diagnosis of HF, where the patient exhibited new or worsening symptoms of HF on presentation and received initiation or intensi cation of treatment speci cally for HF that occurred from the rst month after hospital discharge (25).…”

Section: Follow-up and Outcomesmentioning

confidence: 99%

Incremental prognostic value of global longitudinal strain to the coronary microvascular resistances in Takotsubo patients

Sans‐Roselló

Fernández-Peregrina

Durán-Cambra

et al. 2022

Int J Cardiovasc Imaging

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Background: Global longitudinal strain (GLS) allows an accurate assessment of left ventricular function with prognostic value. We aimed to evaluate whether the assessment of GLS in the acute phase of Takotsubo syndrome (TTS) provides incremental prognostic value to the degree of impaired microvascular resistance (MR) in TTS patients at 1-year follow-up.Methods: We recruited 78 consecutive patients admitted for TTS who underwent cardiac angiography and echocardiography from January 2017 to June 2021. Left anterior descending coronary artery nonhyperaemic angiography-derived index of microcirculatory resistance (LAD NH-IMRangio) was calculated.NT-proBNP, high-sensitive cardiac troponin T (hs-cTnT), left ventricular ejection fraction (LVEF) and GLS were measured at admission. Major adverse cardiac events (MACE) were de ned as the composite of cardiovascular death, heart failure (HF) events, symptomatic arrythmias and acute myocardial infarctions.Results: 67 patients had both GLS and NH-IMRangio available. Median age was 75.2 years and 88 % were women. Rate of MACE at 1-year was 23.9% mainly due to mild HF events. Kaplan-Meier curves showed higher rates of MACE at 1-year in patients with both higher LAD NH-IMRangio and GLS values compared with those with higher LAD NH-IMRangio and lower GLS values (60.0% vs 22.2%; p=0.0373).NT-proBNP levels at admission and the recovery of LVEF were correlated with GLS values while MR and hs-cTnT were not.Conclusions: GLS provides incremental prognostic value to the degree of impaired MR in TTS patients.The combination of a poorer GLS with a higher degree of impaired MR was associated with a higher rate of MACE in these patients.

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Section: Follow-up and Outcomesmentioning

confidence: 99%

Incremental prognostic value of global longitudinal strain to the coronary microvascular resistances in Takotsubo patients

Sans‐Roselló

Fernández-Peregrina

Durán-Cambra

et al. 2022

Int J Cardiovasc Imaging

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“…Cardiac complications remain a leading cause of postoperative morbidity and mortality 1 , 2 . The occurrence of cardiac complications following coronary intervention is well described by the 4th Universal Definition of Myocardial Infarction 3 . However, there is increasing recognition of myocardial injury following non-cardiac surgery (MINS) 4 .…”

Section: Introductionmentioning

confidence: 99%

“…However, there is increasing recognition of myocardial injury following non-cardiac surgery (MINS) 4 . A diagnosis of MINS is made through the presence of elevated cardiac troponin levels, thought to be ischaemic in nature, without associated ischaemic features (for example chest pain or ECG changes), which occur within 30 days of surgery 2 , 3 , 5–7 .…”

Section: Introductionmentioning

confidence: 99%

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Long-term major adverse cardiovascular events following myocardial injury after non-cardiac surgery: meta-analysis

et al. 2023

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Background Myocardial injury after non-cardiac surgery is diagnosed following asymptomatic troponin elevation in the perioperative interval. Myocardial injury after non-cardiac surgery is associated with high mortality rates and significant rates of major adverse cardiac events within the first 30 days following surgery. However, less is known regarding its impact on mortality and morbidity beyond this time. This systematic review and meta-analysis aimed to establish the rates of long-term morbidity and mortality associated with myocardial injury after non-cardiac surgery. Methods MEDLINE, Embase and Cochrane CENTRAL were searched, and abstracts screened by two reviewers. Observational studies and control arms of trials, reporting mortality and cardiovascular outcomes beyond 30 days in adult patients diagnosed with myocardial injury after non-cardiac surgery, were included. Risk of bias was assessed using the Quality in Prognostic Studies tool. A random-effects model was used for the meta-analysis of outcome subgroups. Results Searches identified 40 studies. The meta-analysis of 37 cohort studies found a rate of major adverse cardiac events-associated myocardial injury after non-cardiac surgery of 21 per cent and mortality following myocardial injury after non-cardiac surgery was 25 per cent at 1-year follow-up. A non-linear increase in mortality rate was observed up to 1 year after surgery. Major adverse cardiac event rates were also lower in elective surgery compared with a subgroup including emergency cases. The analysis demonstrated a wide variety of accepted myocardial injury after non-cardiac surgery and major adverse cardiac events diagnostic criteria within the included studies. Conclusion A diagnosis of myocardial injury after non-cardiac surgery is associated with high rates of poor cardiovascular outcomes up to 1 year after surgery. Work is needed to standardize diagnostic criteria and reporting of myocardial injury after non-cardiac surgery-related outcomes. Registration This review was prospectively registered with PROSPERO in October 2021 (CRD42021283995).

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“…Acute myocardial infarction (AMI), as one of the most common cardiovascular diseases, remains a major cause of global morbidity and mortality worldwide, and imposes immense health and economic burden (Domienik-Karłowicz et al. 2021 ). Clinically, the most effective treatments to reduce the infarct size and improve the clinical outcome are timely myocardial reperfusion using thrombolytic therapy and percutaneous coronary intervention.…”

Section: Introductionmentioning

confidence: 99%

Guanxin V attenuates myocardial ischaemia reperfusion injury through regulating iron homeostasis

Zhou

Wang

Zhu

et al. 2022

Pharmaceutical Biology

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Context Guanxin V (GX), a traditional Chinese medicine formula, is safe and effective in the treatment of coronary artery disease. However, its protective effect on myocardial ischaemia reperfusion injury (MIRI) is unclear. Objective To investigate the cardioprotective effect of GX on MIRI and explore the potential mechanism. Materials and methods Sprague-Dawley male rats were divided into Sham, MIRI and MIRI + GX groups. GX (6 g/kg) was administered to rats via intragastric administration for seven days before ischaemia reperfusion (IR) surgery. The infarct size, histopathology, serum enzyme activities, ultrastructure of the cardiac mitochondria were assessed. H9c2 cells were pre-treated with GX (0.5 mg/mL), and then exposed to hypoxia/reoxygenation (HR). The cell viability and LDH levels were measured. Network pharmacology was conducted to predict the potential mechanism. The related targets of GX were predicted using the TCMSP database, DrugBank database, etc. Finally, pharmacological experiments were used to validate the predicted results. Results In vivo , GX significantly reduced the myocardial infarct size from 56.33% to 17.18%, decreased the levels of AST (239.32 vs. 369.18 U/L), CK-MB (1324.61 vs. 2066.47 U/L) and LDH (1245.26 vs. 1969.62 U/L), and reduced mitochondrial damage. In vitro , GX significantly increased H9c2 cell viability (IC 50 = 3.913 mg/mL) and inhibited the release of LDH (207.35 vs. 314.33). In addition, GX could maintain iron homeostasis and reduce oxidative stress level by regulating iron metabolism-associated proteins. Conclusions GX can attenuate MIRI via regulating iron homeostasis, indicating that GX may act as a potential candidate for the treatment of MIRI.

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Fourth universal definition of myocardial infarction. Selected messages from the European Society of Cardiology document and lessons learned from the new guidelines on ST-segment elevation myocardial infarction and non-ST-segment elevation-acute coronary syndrome

Cited by 36 publications

References 27 publications

Incremental prognostic value of global longitudinal strain to the coronary microvascular resistances in Takotsubo patients

Incremental prognostic value of global longitudinal strain to the coronary microvascular resistances in Takotsubo patients

Long-term major adverse cardiovascular events following myocardial injury after non-cardiac surgery: meta-analysis

Guanxin V attenuates myocardial ischaemia reperfusion injury through regulating iron homeostasis

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