Share This Article:

Prognostic implications of type 2 myocardial infarctions

Abstract Full-Text HTML Download Download as PDF (Size:170KB) PP. 237-241
DOI: 10.4236/wjcd.2012.24039    4,882 Downloads   8,475 Views   Citations

ABSTRACT

Purpose: A type 2 myocardial infarction (MI) is due to ischemia from increased oxygen demand or decreased supply. It is not an infrequent complication following non-cardiac surgery or in the setting of acute medical illness. The purpose of this study was to determine whether type 2 MIs had a worse prognosis than a type 1 MI. Methods: The hospital database of a large terti-ary-level academic medical center was queried for all patients with a troponin I ≥ 1.6 ng/mL during a one-year period. The outcomes of patients with a type 2 MI were compared to those with a type 1 MI. Results: This retrospective study found that a type 2 MI is more lethal than the usual type 1 MI, particularly among women and the elderly. There was no statistical difference in outcomes between those that occurred in the post-operative setting compared to those that occurred in the setting of acute medical illness. Conclusions: Type 2 MIs are common and are associated with increased mortality, as compared with type 1 MIs. To date, no guidelines exist for the management of this type of MI. Further research into underlying mechanisms resulting in type 2 MI as well as potential treatment strategies is needed.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

El-Haddad, H. , Robinson, E. , Swett, K. and Wells, G. (2012) Prognostic implications of type 2 myocardial infarctions. World Journal of Cardiovascular Diseases, 2, 237-241. doi: 10.4236/wjcd.2012.24039.

References

[1] Alpert, J.S., Thygesen, K., Antman, E. and Bassand, J.P. (2000) Myocardial infarction redefined—A consensus document of the Joint European Society of Cardiology/ American College of Cardiology Committee for the redefinition of myocardial infarction. Journal of the American College of Cardiology, 36, 959-969. doi:10.1016/S0735-1097(00)00804-4
[2] Jaffe, A.S., Ravkilde, J., Roberts, R., Naslund, U., Apple, F.S., Galvani, M. and Katus, H. (2000) It’s time for a change to a troponin standard. Circulation, 102, 1216-1220. doi:10.1161/01.CIR.102.11.1216
[3] Thygesen, K., Alpert, J.S., White, H.D., Joint ESC/ACCF/ AHA/WHF Task Force for the Redefinition of Myocar- dial Infarction, Jaffe, A.S., Apple, F.S., Galvani, M., Katus, H.A., Newby, L.K., Ravkilde, J., Chaitman, B., Clemmensen, P.M., Dellborg, M., Hod, H., Porela, P., Underwood, R., Bax, J.J., Beller, G.A., Bonow, R., Van der Wall, E.E., Bassand, J.P., Wijins, W., Ferguson, T.B., Steg, P.G., Uretsky, B.F., Williams, D.O., Armstrong, P.W., Antman, E.M., Fox, K.A., Hamm, C.W., Ohman, E.M., Simoons, M.L., Po
[4] Antman, E.M., Hand, M., Armstrong, P.W., Bates, E.R., Green, L.A., Halasyamani, L.K., Hochman, J.S., Krumholz, H.M., Lamas, G.A., Mullany, C.J., Pearle, D.L., Sloan, M.A., Smith, S.C.Jr., 2004 Writing Committee Members, Anbe, D.T., Kushner, F.G., Ornato, J.P., Jacobs, A.K., Adams, C.D., Anderson, J.L., Buller, C.E., Creager, M.A., Ettinger, S.M., Halperin, J.L., Hunt, S.A., Lytle, B.W., Nishimura, R., Page, R.L., Riegel, B., Tarkington, L.G. and Yancy, C.W. (2008) 2007 focused update of the ACC/AHA 2004 gui
[5] Anderson, J.L., Adams, C.D., Antman, E.M., Bridges, C.R., Califf, R.M., Casey, D.E., Chavey, W.E.2., Fesmire, F.M., Hochman, J.S., Levin, T.N., Lincoff, A.M., Peterson, E.D., Theroux, P., Wenger, N.K., Wright, R.S., Smith, S.C.Jr., Jacobs, A.K., Adams, C.D., Anderson, J.L., Antman, E.M., Halperin, J.L., Hunt, S.A., Krumholz, H.M., Kushner, F.G., Lytle, B.W., Nishimura, R., Ornato, J.P., Page, R.L., Riegel, B. (2007) ACC/AHA 2007 guidelines for the management of patients with unstable angina/non-ST-elevation
[6] Landesberg, G., Beattie, W.S., Mosseri, M., Jaffe, A.S. and Alpert, J.S. (2009) Perioperative myocardial infarction. Circulation, 119, 2936-2944. doi:10.1161/CIRCULATIONAHA.108.828228
[7] Auerbach, A.D. and Goldman, L. (2002) Beta-blockers and reduction of cardiac events in noncardiac surgery. JAMA, 287, 1435-1444. doi:10.1001/jama.287.11.1435
[8] Stevens, R.D., Burri, H. and Tramer, M.R. (2003) Pharmacologic myocardial protection in patients undergoing noncardiac surgery: A quantitative systematic review. Anes- thesia & Analgesia, 97, 623-633. doi:10.1213/01.ANE.0000074795.68061.16
[9] Fleisher, L.A., Beckman, J.A., Brown, K.A., Calkins, H., Chaikof, E.L., Fleischmann, K.E., Freeman, W.K., Froehlich, J.B., Kasper, E.K., Kersten, J.R., Riegel, B., Robb, J.F., Smith, S.C.Jr., Jacobs, A.K., Adams, C.D., Anderson, J.L., Antman, E.M., Buller, C.E., Creager, M.A., Ettinger, S.M., Faxon, D.P., Fuster, V., Halperin, J.L., Hiratzka, L.F., Hunt, S.A., Lytle, B.W., Nishimura, R., Ornato, J.P., Page, R.L., Riegel, B., Tarkington, L.G. and Yancy, C.W. (2007) ACC/AHA 2007 guidelines on perioperative ca
[10] POISE Study Group, Devereaux, P.J., Yang, H., Yusuf, S., Guyatt, G., Leslie, K., Villar, J.C., Xavier, D., Chrolavicius, S., Greenspan, L., Pogue, J., Pais, P., Liu, L., Xu, S., Malaga, G., Avezum, A., Chan, M., Montori, V.M., Jacka, M. and Choi, P. (2008) Effects of extended- release metoprolol succinate in patients undergoing non- cardiac surgery (POISE trial): A randomised controlled trial. Lancet, 371, 1839-1847. doi:10.1016/S0140-6736(08)60601-7
[11] Ammann, P., Fehr, T., Minder, E.I., Gunter, C. and Bertel, O. (2001) Elevation of troponin 1 in sepsis and septic shock. Intensive Care Medicine, 27, 965-969. doi:10.1007/s001340100920
[12] Kumar, A., Thota, V., Dee, L., Olson, J., Uretz, E. and Parrillo, J.E. (1996) Tumor necrosis factor and interleukin 1beta are responsible for in vitro myocardial cell depression induced by human septic shock serum. The Journal of Experimental Medicine, 183, 949-958. doi:10.1084/jem.183.3.949
[13] McFalls, E.O., Ward, H.B., Santilli, S., Scheftel, M., Chesler, E. and Doliszny, K.M. (1998) The influence of perioperative myocardial infarction on long-term prognosis following elective vascular surgery. Chest, 113, 681- 686. doi:10.1378/chest.113.3.681
[14] Devereaux, P.J., Xavier, D., Pogue, J., Guyatt, G., Sigamani, A., Garutti, I., Leslie, K., Rao-Melacini, P., Chrolavicius, S., Yang, H., MacDonald, C., Avezum, A., Lanthier, L., Hu, W. and Yusuf, S. on behalf of the POISE (PeriOperative ISchemic Evaluation) Investigators (2011) Characteristics and short-term prognosis of perioperative myocardial infarction in patients undergoing noncardiac surgery. Annals of Internal Medicine, 154, 523-528.

  
comments powered by Disqus

Copyright © 2019 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.