The appropriateness of coronary investigation in myocardial injury and type 2 myocardial infarction (ACT-2): A randomized trial design

Abstract

Chew , The appropriateness of coronary investigation in myocardial injury and Type 2 myocardial infarction (ACT-2): A randomized trial design. Ymhj (2018),

Myocardial Injury in the Era of High-Sensitivity Cardiac Troponin Assays

“…65 primary endpoint of all-cause mortality at 2 years. 68 Cost-effectiveness will be determined based on clinical events, quality of life, and resource utilization over 24 months. 68 Beyond those patients with ischemic myocardial injury, unfortunately, no consensus exists regarding routine management of patients with myocardial injury.…”

High-sensitivity troponin in chronic kidney disease: Considerations in myocardial infarction and beyond

“…In contrast, myocardial injury is defined as an elevated troponin without evidence of myocardial ischaemia and is subdivided into acute and chronic injury depending on the presence or absence of an observed rise and/or fall in troponin levels, respectively (Thygesen et al, 2018). In patients with CKD, acute and chronic myocardial injury likely account for a substantial portion of troponin elevations (Janzon et al, 2016;Lambrakis et al, 2019;Taylor et al, 2007;Thygesen et al, 2010). Indeed, in two recent large randomised trials of hs-cTn in clinical practice involving 48,282 and 3,378 patients both acute and chronic myocardial injury was found to account for at least 30% of patients with ele-vated troponin (Chew et al, 2019;Shah et al, 2018).…”

“…Currently, there are two ongoing randomised trials investigating the role of invasive coronary assessment in patients with myocardial injury: ACT-2 (The Appropriateness of Coronary investigation in myocardial injury and Type 2 myocardial infarction, AC-TRN12618000378224) (Lambrakis et al, 2019) and DEMAND MI (DEtermining the Mechanism of myocardial injury AND role of coronary disease in type 2 Myocardial Infarction, NCT03338504).…”

Metoprolol protects against myocardial infarction by inhibiting miR-1 expression in rats

“…[1,2] MI is characterized by myocardial cell necrosis due to the prolonged insufficient coronary oxygen and nutrient supply. [3] As a selective b1-adrenoceptor antagonist, the inexpensive medication metoprolol has been regarded as a common cardiovascular medication for acute myocardial infarction (AMI), alleviating the ischaemia and reperfusion damage and reducing the risk of perioperative cardiac complications. [4] However, the essential mechanism through which metoprolol exerts its cardioprotective effects remains largely unknown.…”