Epidemiological classification of acute myocardial infarction: time for a change?

Abstract

The epidemiological classification of suspected acute myocardial infarction could be based solely on a specific cardiac marker, such as creatine kinase MB mass. This approach contains prognostic information and is accurate enough for the structured diagnosis of acute myocardial infarction. Other outcome predictors could be used to identify patient subgroups and assess therapy.

Universal Definition of Myocardial Infarction

“…The specificity of the ECG diagnosis for myocardial infarction is greatest when Q-waves occur in several leads or lead groupings. ST deviations or T-waves alone are non-specific findings for Other validated myocardial infarction-coding algorithms, such as the Minnesota code, Novacode, and WHO MONICA, define Q-wave depth on the basis of depth, width, and ratio of R-wave amplitude, such as Q-wave depth at least one-third or one-fifth of R-wave amplitude, and have been used extensively in epidemiological studies and clinical trials (36,37).…”

Universal Definition of Myocardial Infarction

“…В других утвержденных алгоритмах диагностики инфаркта миокарда, таких как Миннесотский код, Novacode и MONICA, глубокий зубец Q определяется на основании глубины, ширины и отношения к амплитуде зубца R (например, глубина зубца Q, по крайней мере, 1/3 или 1/5 по отношению к амплитуде зубца R). Эти критерии широко использовались в эпидемиологических и клинических исследованиях [36,37].…”

Evolution of the definition of myocardial infarction: what are the implications of a new universal definition?

“…In 1999, a Finnish study18 found poor correlation between the WHO definition of infarction and diagnosis of MI when CKMB was introduced. In this study typical chest pain and a Minnesota ECG code fulfilling the Monitoring Trends and Determinants in Cardiovascular Disease World Health Organisation (MONICA WHO) criteria for MI had no prognostic importance but a classification based on creatine kinase MB was the strongest predictor of 1-year and 5-year mortality.…”