Wake Forest University long‐term follow‐up of type 2 myocardial infarction: The Wake‐Up T2MI Registry

Jogu, Hanumantha R; Arora, Sameer; Vaduganathan, Muthiah; Qamar, Arman; Pandey, Ambarish; Chevli, Parag A; Pansuriya, Tusharkumar; Ahmad, Muhammad Imtiaz; Dutta, Abhishek; Sunkara, Padageshwar; Qureshi, Waqas; Vasu, Sujethra; Upadhya, Bharathi; Bhatt, Deepak L.; Januzzi, James L.; Herrington, David M.

doi:10.1002/clc.23182

Cited by 4 publications

(6 citation statements)

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“…MI is defined as the presence of elevated cardiac troponin (myocardial injury) in the setting of evidence of acute myocardial ischemia. 27,28 Signs and symptoms of myocardial ischemia include any one of these features: chest pain; shortness of breath; atypical symptoms, such as arm, neck, and jaw discomfort, epigastric pain, and nausea; electrocardiogram (EKG) ischemic changes; new regional wall motion abnormalities on echocardiogram (ECHO); and identification of thrombus on coronary angiography or autopsy. 27 With the increasing heterogeneity of MI, the 2018 Joint European Society of Cardiology/American College of Cardiology Foundation/American Heart Association/World Heart Federation Task Force classified five subtypes of MI based on the pathophysiological nature of MI.…”

Section: Pathophysiology and Types Of Myocardial Infarctionmentioning

confidence: 99%

“…Type 1 MI is due to atherosclerotic plaque pathology, whereas type 2 MI represents demand-supply mismatch (increased myocardial oxygen demand and/or reduced supply) in the absence of atherothrombotic plaque disruption. [27][28][29] Type 3, type 4, and type 5 MIs occur due to cardiac death prior to cardiac troponin detection, post-PCI, and post-coronary artery bypass grafting (CABG), respectively. 27 Nonischemic myocardial injury, on the other hand, is seen in patients with abnormally elevated troponin without any signs or symptoms of myocardial ischemia-without chest pain or EKG changes or ECHO changes.…”

Section: Pathophysiology and Types Of Myocardial Infarctionmentioning

confidence: 99%

“…27,29,32 This non-ACS troponin elevation population has both short-and long-term all-cause mortality equal to or slightly higher than type 1 MI. [27][28][29]32,47 History of coronary artery disease is an independent predictor of major adverse cardiovascular events in these patients. 47 Statins, antiplatelet agents, and β-blockers in the subset of nonischemic myocardial injury patients (sepsis and perioperative patients) showed some beneficial effect.…”

Section: Management Of Type 2 MI and Nonischemic Myocardial Injury During Strokementioning

confidence: 99%

“…29,[72][73][74][75][76] Limited data exist defining optimal treatment strategies for these categories due to the heterogenous nature with varying etiologies and triggers. [27][28][29]32 In the presence of elevated troponin, clinicians should be vigilant while excluding AMI/ACS from the non-ACS troponin elevation group, as AMI/ACS requires heparin infusion and/or antiplatelet agent administration. In the setting of progressively elevated troponin levels, if a patient has chest pain or chest pain equivalent symptoms or new abnormal EKG or new abnormal echocardiograph, the likelihood ratio of AMI/ACS is high.…”

Section: Management Of Type 2 MI and Nonischemic Myocardial Injury During Strokementioning

confidence: 99%

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Acute Ischemic Stroke Associated with Myocardial Infarction: Challenges and Management

2021

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Acute ischemic stroke (AIS) and acute myocardial infarction (AMI) may co-occur simultaneously or in close temporal succession, with occurrence of one ischemic vascular event increasing a patient's risk for the other. Both employ time-sensitive treatments, and both benefit from expert consultation. Patients are at increased risk of stroke for up to 3 months following AMI, and aggressive treatment of AMI, including use of reperfusion therapy, decreases the risk of AIS. For patients presenting with AIS in the setting of a recent MI, treatment with alteplase, an intravenous tissue plasminogen activator, can be given, provided anterior wall myocardial involvement has been carefully evaluated. It is important for clinicians to recognize that troponin elevations can occur in the setting of AIS as well as other clinical scenarios and that this may have implications for short- and long-term mortality.

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Section: Pathophysiology and Types Of Myocardial Infarctionmentioning

confidence: 99%

Section: Pathophysiology and Types Of Myocardial Infarctionmentioning

confidence: 99%

Section: Management Of Type 2 MI and Nonischemic Myocardial Injury During Strokementioning

confidence: 99%

Section: Management Of Type 2 MI and Nonischemic Myocardial Injury During Strokementioning

confidence: 99%

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Acute Ischemic Stroke Associated with Myocardial Infarction: Challenges and Management

2021

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“…Type 2 myocardial infarction (T2MI) refers to MI caused by an imbalance between myocardial oxygen supply and demand in the absence of occlusion of the coronary arteries [ 1 ]. Conditions that decrease oxygen supply and/or increase oxygen demand of the heart, e.g., anemia, hypotension, and arrhythmia, increase the risk of T2MI [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Correlation between Traditional Chinese Medicine Syndromes and Type 2 Myocardial Infarction in Critically Ill Patients with Pulmonary Disease

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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Background. Treatment based on syndrome differentiation under the traditional Chinese medicine (TCM) framework has been shown to be helpful in patients with coronary artery disease. We hypothesized that syndrome types could predict the risk of type 2 myocardial infarction (T2MI) caused by imbalance between myocardial oxygen supply and demand in critically ill patients with pulmonary disease. Methods. This retrospective study included consecutive critically ill patients with pulmonary disease admitted to the ICU at Jiading District Central Hospital Affiliated Shanghai University of Medicine & Health Sciences from January 1, 2017, to July 1, 2019. Diagnosis of T2MI was based on the fourth universal definition of myocardial infarction. Risk factors associated with T2MI were identified using multivariate regression analysis. Results. A total of 244 patients were included in the study: 78 who developed T2MI and the remaining 166 who did not develop T2MI during hospitalization. The incidence of phlegm syndrome and deficiency syndrome was 61.9% and 38.1%, respectively. In comparison with the patients with phlegm syndrome, the incidence of T2MI in patients with deficiency syndrome is significantly higher (40.9% vs. 26.5%, P = 0.019 ). In multivariate logistic regression, T2MI was independently associated with the baseline troponin level (OR 12.682, 95% CI 1.397∼115.121; P = 0.024 ), hemoglobin < 55 g/L (OR 12.76, 95% CI 2.359∼69.021; P = 0.003 ), mechanical ventilation (OR 2.244, 95% CI 1.029∼4.892; P = 0.042 ), and TCM deficiency syndrome (OR 2.214, 95% CI 1.032∼4.749; P = 0.041 ). After adjusting for confounding factors in Cox regression models, the hazard ratio (95% confidence interval) of qi deficiency syndrome groups was 1.183 (95% CI 1.053∼3.123, P = 0.032 ). Conclusions. Patients with deficiency syndrome are at high risk of T2MI, especially those combined with qi deficiency syndrome.

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Controversial issues of type 2 myocardial infarction patients management

Kinash

Воробьев²,

Урванцева³

et al. 2022

Kompleks. probl. serdečno-sosud. zabol.

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Highlights. The article presents relevant literary data on the epidemiology, main causes, approaches to the diagnostics and treatment of type 2 myocardial infarction patients. The authors emphasize an unfavorable prognosis in these patients due to comorbidity that leads to development of myocardial infarction. They highlight the need to improve and unify approaches to identifying this phenomenon, as well as the necessity to conduct observational and randomized studies to evaluate approaches to the treatment of type 2 myocardial infarction patients.Abstract. The article summarizes the available data from clinical trials and current guidelines, approaches to the definition and type 2 myocardial infarction (MI) differential diagnosis in clinical practice. The attention is focused on the fundamental difference between type 1 and type 2 MI and the need to consider the comorbidities for the identification of etiological factors type 2 MI development. The lack of evidencebased medical data regarding the prognosis and effective treatment of patients with type 2 MI is emphasized. Nevertheless, such patients are characterized with high rates of overall and cardiovascular mortality in hospital and long-term disease course, as well as a high rate of readmission. Thus, there is the need for multicenter observational studies of type 2 MI patients and the development of algorithms for treatment and rehabilitation of this category of patients.

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Wake Forest University long‐term follow‐up of type 2 myocardial infarction: The Wake‐Up T2MI Registry

Cited by 4 publications

References 39 publications

Acute Ischemic Stroke Associated with Myocardial Infarction: Challenges and Management

Acute Ischemic Stroke Associated with Myocardial Infarction: Challenges and Management

Correlation between Traditional Chinese Medicine Syndromes and Type 2 Myocardial Infarction in Critically Ill Patients with Pulmonary Disease

Controversial issues of type 2 myocardial infarction patients management

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