World Health Organization definition of myocardial infarction: 2008-09 revision

Mendis, Shanthi; Thygesen, Kristian; Kuulasmaa, Kari; Giampaoli, Simona; Mähönen, Markku; Blackett, Kathleen Ngu; Liu, Lisheng

doi:10.1093/ije/dyq165

Cited by 396 publications

(260 citation statements)

References 10 publications

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“…These observations lend support to the need for clear diagnostic criteria, and management guidelines for type 2 MI. As the WHO endorses the ICD coding system as the standard diagnostic tool for epidemiology, health management, and clinical purposes, the inclusion of type-2 MI in the ICD-10 coding system is necessary (34 focused on epidemiology, management, and outcomes using the available databases. Our study had several limitations.…”

Section: Discussionmentioning

confidence: 99%

Type 2 versus type 1 myocardial infarction: a comparison of clinical characteristics and outcomes with a meta-analysis of observational studies

Gupta¹,

Vaidya²,

Arora³

et al. 2017

Cardiovasc. Diagn. Ther.

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Background: Type 2 myocardial infarction (MI) is an imbalance between myocardial oxygen demand and supply, leading to myocardial ischemia. It is not due to plaque rupture, and is usually caused by a condition other than coronary artery disease (CAD). However, limited data are available comparing the prevalence of traditional coronary risk factors and mortality between type 1 and type 2 MI. We hypothesize that type 2 MI carries a higher mortality than type 1. Methods:We searched the databases of PubMed, EMBASE, CENTRAL, and MEDLINE for studies comparing type 1 MI with type 2 MI. The baseline variables were compared in each cohort. Summary risk ratios and 95% confidence intervals were calculated using the random effects model to compare mortality between the two groups. Results:The included studies yielded 25,872 patients of whom 2,683 (10%) had type 2 MI. Compared to the type 1 cohort, the type 2 cohort had significantly higher inpatient (15% vs. 4.7%, P<0.00001), 30-day (17.6% vs. 5.3%, P<0.00001) and 1-yr mortality (27% vs. 13%, P<0.00001), as well as higher 30-day major adverse cardiovascular events (20% vs. 9%, P<0.0001). Operative stress (20%) was the most common trigger of type 2 MI, followed by sepsis (19%), arrhythmia (18.63%), heart failure (15%), and anemia (12%).Conclusions: Type 2 MI is a common entity and is more common in females, older age groups, and in patients with multiple comorbidities: it also tends to result in higher mortality.

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Section: Discussionmentioning

confidence: 99%

Type 2 versus type 1 myocardial infarction: a comparison of clinical characteristics and outcomes with a meta-analysis of observational studies

Gupta¹,

Vaidya²,

Arora³

et al. 2017

Cardiovasc. Diagn. Ther.

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show abstract

“…If we focus our attention on the comparison of rates of positive cTn results between assay generations, it is apparent that lowering the cutoff at the 99th percentile limit and increasing the assay sensitivity has resulted in (a) a shift from diagnoses of unstable angina (UA) to AMI and (b) more cases of cTn increase caused by non-ischemic cardiac necrosis. The World Health Organization, during 2008-2009, reported there was a relevant shift from diagnoses of UA to AMI [31]. This demonstrated that the definition of UA is strongly influenced by the assay used to measure cTn and will be affected by the implementation of hsTn, namely by the increased capability to detect very minor myocardial necrosis [32].…”

Section: : Increasing Ctn Positivity Ratesmentioning

confidence: 99%

Laboratory medicine as the science that underpins medicine: the “high-sensitivity” troponin paradigm

Ferraro¹,

Panteghini

2015

Clinical Chemistry and Laboratory Medicine (CCLM)

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Abstract:The availability of so-called high-sensitivity troponin assays (hsTn) has scored a compelling goal for laboratory medicine, allowing the safe clinical application of international recommendations for the definition of acute myocardial infarction (AMI). However, the introduction of hsTn has not been welcomed by clinicians, claiming an increase in false-positive results. Here we critically trace back the steps following the introduction of hsTn by referring to the 5-year practical experience in our academic hospital and to suitable information available in the literature. In agreement with published data, we found that hsTn introduction was associated with an increased number of AMI diagnoses, whereas the test volume, the revascularization rate, and the proportion of cases with negative angiography findings remained virtually unchanged. Fast-track protocols for ruling out AMI have been further optimized to recommend sampling at presentation and after 3 h only. We focus on a cost-effective use of hsTn that can account for all clinical variables increasing the pre-test probability in order to ensure that tests are ordered only for patients at medium to high risk for acute coronary syndrome (ACS). To guide interpretation of results, hsTn typical release patterns suggestive for AMI should be identified by evaluating the significance of concentration changes. hsTn have markedly shortened the time to rule out or rule in AMI and has the potential to improve the prognostic assessment of critical patients in clinical contexts different from ACS.

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“…On a global scale, cardiovascular disease is responsible for around 30% of human mortality as well as 10% of the disease burden [4,5]. In 2005, 17 million out of 58 million deaths worldwide were caused by cardiovascular disease [6,7,8,9]. According to the statistics, published in 2013, the various risk factors causing death are 40.6% due to high blood pressure, 13.7% came from smoking, 13.2% resulted from a poorly balanced diet, 11.9% are attributed to insufficient physical exercise and 20.6% could not be attributed [10,11].…”

Section: Introductionmentioning

confidence: 99%

Computer aided diagnosis of Coronary Artery Disease, Myocardial Infarction and carotid atherosclerosis using ultrasound images: A review

et al. 2017

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World Health Organization definition of myocardial infarction: 2008-09 revision

Abstract: This article presents the 2008-09 revision of the World Health Organization (WHO) definition of myocardial infarction (MI) developed at a WHO expert consultation.

Cited by 396 publications

References 10 publications

Type 2 versus type 1 myocardial infarction: a comparison of clinical characteristics and outcomes with a meta-analysis of observational studies

Type 2 versus type 1 myocardial infarction: a comparison of clinical characteristics and outcomes with a meta-analysis of observational studies

Laboratory medicine as the science that underpins medicine: the “high-sensitivity” troponin paradigm

Computer aided diagnosis of Coronary Artery Disease, Myocardial Infarction and carotid atherosclerosis using ultrasound images: A review

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