Type 2 myocardial infarction due to supply–demand mismatch

Mihatov, Nino; Januzzi, James L.; Gaggin, Hanna K.

doi:10.1016/j.tcm.2017.03.002

Cited by 23 publications

(19 citation statements)

References 41 publications

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“…We observed differences in type of ACS presentation in patients with leukaemia, with STEMI occurring less commonly. This may be because of greater prevalence of type 2 AMIs secondary to supply/demand mismatch in this cohort, related to their disease‐specific comorbidities (anaemia, sepsis, dehydration, drug toxicity, etc). Patients with leukaemia also had significantly higher prevalence of thrombocytopenia (>10% prevalence in all types of leukaemia compared with 3% in patients without leukaemia) with the highest rates (one‐quarter) in those with AML.…”

Section: Discussionmentioning

confidence: 95%

Management strategies and clinical outcomes of acute myocardial infarction in leukaemia patients: Nationwide insights from United States hospitalisations

et al. 2020

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Summary Background Patients with leukaemia are at increased risk of cardiovascular events. There are limited outcomes data for patients with a history of leukaemia who present with an acute myocardial infarction (AMI). Methods We queried the Nationwide Inpatient Sample (2004‐2014) for patients with a primary discharge diagnosis of AMI, and a concomitant diagnosis of leukaemia, and further stratified according to the subtype of leukaemia. Multivariable logistic regression was conducted to identify the association between leukaemia and major acute cardiovascular and cerebrovascular events (MACCE; composite of mortality, stroke and cardiac complications) and bleeding. Results Out of 6 750 878 AMI admissions, a total of 21 694 patients had a leukaemia diagnosis. The leukaemia group experienced higher rates of MACCE (11.8% vs 7.8%), mortality (10.3% vs 5.8%) and bleeding (5.6% vs 5.3%). Following adjustments, leukaemia was independently associated with increased odds of MACCE (OR 1.26 [1.20, 1.31]) and mortality (OR 1.43 [1.37, 1.50]) without an increased risk of bleeding (OR 0.86 [0.81, 0.92]). Acute myeloid leukaemia (AML) was associated with approximately threefold risk of MACCE (OR 2.81 [2.51, 3.13]) and a fourfold risk of mortality (OR 3.75 [3.34, 4.22]). Patients with leukaemia were less likely to undergo coronary angiography (CA) (48.5% vs 64.5%) and percutaneous coronary intervention (PCI) (28.2% vs 42.9%) compared with those without leukaemia. Conclusion Patients with leukaemia, especially those with AML, are associated with poor clinical outcomes after AMI, and are less likely to receive CA and PCI compared with those without leukaemia. A multi‐disciplinary approach between cardiologists and haematology oncologists may improve the outcomes of patients with leukaemia after AMI.

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Section: Discussionmentioning

confidence: 95%

Management strategies and clinical outcomes of acute myocardial infarction in leukaemia patients: Nationwide insights from United States hospitalisations

et al. 2020

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“…Although patients with T2MI have higher rates of all‐cause death compared with those with type 1 myocardial infarction (T1MI), few studies report that the causes of T2MI are associated with a higher mortality rate. In addition, distinguishing different etiologies is essential for clinical management in patients with T2MI, mainly because a large spectrum of underlying causes for T2MI leads to an array of different treatment strategies . Hence, the aim of this review is to assess the triggers of T2MI and to summarize the clinical features of patients with T2MI described in the literature.…”

Section: Introductionmentioning

confidence: 99%

“…In addition, distinguishing different etiologies is essential for clinical management in patients with T2MI, mainly because a large spectrum of underlying causes for T2MI leads to an array of different treatment strategies. [6][7][8][9] Hence, the aim of this review is to assess the triggers of T2MI and to summarize the clinical features of patients with T2MI described in the literature.…”

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confidence: 99%

A systematic review on the triggers and clinical features of type 2 myocardial infarction

Wang

Zhao

Zhong

et al. 2019

Clinical Cardiology

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Little is known about the correlation between triggering factors, clinical characteristics, diagnosis, and prognosis of patients with type 2 myocardial infarction (T2MI). The triggers and features of T2MI are linked to its diagnosis and prognosis. The Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines were followed. A structured search of three databases (PubMed, Embase, and Medline) was undertaken to identify peer‐reviewed articles related to the triggers and clinical features of T2MI published between January 2012 and August 2018. Seven retrospective cohort studies and seven prospective cohort studies involving 3867 patients with T2MI were included. All selected studies were rated as being of high or acceptable quality. Nine studies revealed that the leading trigger of T2MI was arrhythmia, especially tachyarrhythmia. Six studies revealed that the proportion of single‐trigger T2MIs was higher than that of multiple triggers and two studies showed that two‐trigger cases formed the majority of multiple trigger cases. All included studies found that a greater prevalence of T2MI in the older population. Thirteen studies revealed that the patients with T2MI often had a previous relevant medical history. The leading trigger of T2MI is arrhythmia, especially tachyarrhythmia, and the majority of cases arise from a single trigger. Two‐trigger is the most common form of multiple‐trigger T2MI, which often occurs in older patients with cardiovascular risk factors or comorbidities. Non‐cardiovascular causes may be the triggering factors and are strongly associated with the diagnosis, treatment, and prognosis of T2MI.

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“…Авторы отмечают, что паци-енты с ИМ 2 типа являлись преимущественно жен-щинами (43,3% и 22,3%, p<0,0001), были достоверно старше (средний возраст 75,6±12 и 63,8±13 лет, p<0,0001), имели более высокий риск по GRACE (средний балл 150±32 и 110±35, p<0,0001), но при этом интервенционные вмешательства в этой группе выполнялись достоверно реже (36% и 89%, p<0,0001), а смертность в течение 1 года была значительно выше (23,9% и 8,6%, p<0,0001) [3]. По данным Mihatov N, et al, частота ИМ 2 типа в различных ретроспективных исследованиях колебалась от 2 до 30%, пациенты были преимущественно женщинами старше 75 лет и имели более низкую фракцию выброса левого желудочка (ФВ) [4].…”

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“…В момент клини-ческой смерти -аналогичный затянувшийся эпизод элевации ST с исходом в фибрилляцию желудочков (рис. [3][4][5].…”

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Vasospasm as a Cause of Type 2 Myocardial Infarction. Tactics Outside the Guidelines

Лысенко¹,

Ванюков²,

Потешкина³

et al. 2017

Russ J Cardiol

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Согласно третьему универсальному определению инфаркта миокарда (ИМ), имеется несколько раз-личных механизмов развития некроза кардиомиоци-тов [1]. ИМ 1 типа обусловлен атеротромбозом, типы 4 и 5 связаны с проведением различного рода меди-цинских манипуляций (чрескожных коронарных вмешательств и коронарного шунтирования). ИМ 3 типа диагностируют у внезапно умерших пациентов при невозможности получения данных о повышении кардиоспецифических ферментов и при наличии предшествующей картины поражения миокарда [1]. Наиболее широким представляется определение ИМ 2 типа, объединившее различные патогенетические механизмы развития некроза кардиомиоцитов, такие как коронарный вазоспазм, эндотелиальная дис-функция, метаболические нарушения и иные при-чины. Единый механизм, за счет которого все эти состояния приводят к ИМ 2 типа -критическое снижение перфузии [1,2].Какие заболевания наиболее часто приводят к раз-витию ИМ 2 типа? Данный тип ИМ может быть обусловлен целым рядом различных состояний и заболеваний, таких как сепсис и септический шок, тяжелая дыхательная недостаточность, тахи-и бради-аритмии, коронароспазм, поражение аортального клапана, васкулит и коронариит, миокардит, травма сердца, тяжелая почечная недостаточность, анемия и некоторые другие. В результате течения вышеука-занных заболеваний создается гемодинамический дисбаланс между потребностью миокарда в кисло-роде и объемом перфузии [1]. Такой дисбаланс может быть обусловлен механическими причинами, как при вазоспазме, а может носить относительный характер, как, например, при тахиаритмиях, когда потребность Лысенко М. А. -д. м.н., главный врач, профессор кафедры общей терапии фДПО, Ванюков А. е. -зав. отделением рентгенэндоваскулярных методов диагностики и лечения, рентгенэндоваскулярный хирург, Потешкина Н. Г. -д. м.н., профессор, зав. кафедрой общей терапии фДПО, врач-кардиолог, суворов А. Ю.* -к. м.н., ассистент кафедры общей терапии фДПО, врач отде-ления функциональной диагностики, самсонова И. В. -к. м.н., заместитель главного врача по медицинской части, Ковалевская е. А. -зав. 2-м кардиоло-гическим отделением.*Автор, ответственный за переписку (Corresponding author): nnexen@gmail.com ДИ -доверительный интервал, ИМ -инфаркт миокарда, КАГ -коронароан-гиография, ОР -относительный риск, ПНА -передняя нисходящая артерия, ссЗ -сердечно-сосудистые заболевания, фВ -фракция выброса, ХМ-эКГ -холтеровское мониторирование, Чсс -частота сердечных сокраще-ний, эКГ -электрокардиограмма, эхо-КГ -эхокардиография. The review is focused on the recent data on the causes of type 2 myocardial infarction and specifics of its diagnostics and management in patients with vasospastic angina. significance of the problem is based upon the fact that strategies of this sort of patients management are lacking and usually do not fit guidelines. There is absence of agreed princips of long term management of such patients. The selection of strategy (medication therapy, revascularization of the spastic region, prevention of complications and another infarction) is disputable. The case prov...

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Type 2 myocardial infarction due to supply–demand mismatch

Cited by 23 publications

References 41 publications

Management strategies and clinical outcomes of acute myocardial infarction in leukaemia patients: Nationwide insights from United States hospitalisations

Management strategies and clinical outcomes of acute myocardial infarction in leukaemia patients: Nationwide insights from United States hospitalisations

A systematic review on the triggers and clinical features of type 2 myocardial infarction

Vasospasm as a Cause of Type 2 Myocardial Infarction. Tactics Outside the Guidelines

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