Type-II MI refers to myocyte necrosis in the setting of a mismatch between oxygen supply and demand due to illnesses, other than acute thrombotic coronary event (Type-I MI). 12 However, differentiation between acute myocardial injury and Type-II MI may be difficult, as, for example, sepsis may provoke both. 7–11 The 4th universal definition of MI has refined diagnoses as Type-I MI, Type-II MI, acute myocardial injury, and chronic myocardial injury. Measurement of levels of high-sensitivity troponins (HsTn) T or I are preferred to detect myocardial infarction (MI) during the assessment of patients presenting to emergency departments (EDs) with suspected acute coronary syndromes (ACS), 1–6 as these are specific markers of myocardial injury or necrosis.
HsTnT, Type-I MI, Type-II MI, Chronic myocardial injury, mortality Introduction On Cox modelling for mortality relative to Type 1 MI, adjusted hazard ratios were 1.94 P = 0.032 for Type 2 MI, and for chronic myocardial injury 1.14 (95% CIs 0.64–2.02) P = 0.66. In-hospital angiography rates were 95% for patients with Type-I MI, 24% (7% PCI) for those with Type-II MI, and 3.4% for chronic myocardial injury. Of 995 patients (36%) with ≥2 HsTnT measurements and one >14 ng/L, 727 (73%) had chronic myocardial injury, 171 (17%) had Type-II MI, and 97 (9.7%) had Type-I MI respective late mortality rates to 48 months were 33%, 43%, and 14% ( P < 0.001).
Adjudication of MI was according to the 4th universal definition as follows: (i) Type-I MI (ii) Type-II MI (including acute myocardial injury), and (iii) chronic myocardial injury. We studied the use of invasive and pharmacological therapies, and 4-year outcomes. Among 2738 consecutive patients with suspected ACS presenting to ED at Liverpool Hospital, Australia, between March and June 2014.
0 kommentar(er)
