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

Further development of an illness perception intervention for myocardial infarction patients: A randomized controlled trial

“…The definition of MI used in this trial is inclusive of patients with less severe pathology than the definition used in the previous trial [21]. Most patients diagnosed with MI today do very well with modern treatments and lifestyle modification [29]. Despite these changes, the intervention was shown to improve rates of return to work in this patient group, including those patients who had experienced previous MI.…”

The impact of the 2007 ESC–ACC–AHA–WHF Universal definition on the incidence and classification of acute myocardial infarction: A retrospective cohort study

“…Overdiagnosing occurred when patients with mild cTNT elevation were assigned an AMI diagnosis despite the lack of ischemic ECG changes or symptoms. The introduction of type 2 AMI resolves some of these issues [21]. The revised diagnostic criteriae of PCI related AMI (type 4) requires 3× elevation of the biomarker cutoff provided there was a normal preprocedure level.…”

“…Most ACS patients are troponin positive, and the proportion which fulfills the AMI criteria will depend on the cutoff of troponin employed [21]. An increasingly larger proportion of the patients with ACS previously diagnosed as unstable angina will therefore be classified as AMI parallel to introduction of even more sensitive and precise troponin assays [21][22][23].…”

“…This may have important social and medical consequences for the patients. Patients belonging to different AMI subclasses may require different treatment [21]. For example, whereas patients with type 1 AMI needs antithrombotic medication and early invasive investigation, type 2 patients often needs medical treatment.…”

The Year in Non–ST-Segment Elevation Acute Coronary Syndrome

“…This year, it is estimated, on average, approximately 1 American will have an acute coronary event every 25 s, resulting in 1 death per minute (2). The prevalence of NSTE-ACS is increasing relative to ST-segment elevation myocardial infarction (STEMI) due to changes in the distribution of risk factors in the population (e.g., older age, predominance of females, higher rate of diabetes) (1), use of preventative medications (3), and increasingly sensitive troponin assays (4). Two risk factors heading in opposite directions are smoking and obesity.…”