TY - JOUR
T1 - Type 2 Myocardial Infarction
T2 - JACC Review Topic of the Week
AU - Sandoval, Yader
AU - Jaffe, Allan S.
N1 - Publisher Copyright:
© 2019 American College of Cardiology Foundation
Copyright:
Copyright 2019 Elsevier B.V., All rights reserved.
PY - 2019/4/16
Y1 - 2019/4/16
N2 - Acute myocardial infarction (MI) can occur from increased myocardial oxygen demand and/or reduced supply in the absence of acute atherothrombotic plaque disruption; a condition called type 2 myocardial infarction (T2MI). As with any MI subtype, there must be clinical evidence of myocardial ischemia to make the diagnosis. This condition is increasingly diagnosed due to the increasing sensitivity of cardiac troponin assays and is associated with adverse short-term and long-term prognoses. Limited data exist defining optimal management strategies because T2MI is a heterogeneous entity with varying etiologies and triggers. Thus, these patients require individualized care. A major barrier is the absence of a uniform definition that can be operationalized with high reproducibility. This document provides a synthesis of the data about T2MI to assist clinicians’ understanding of its pathobiology, when to deploy the diagnosis, and its associated treatments. It also clarifies prognosis, identifies gaps in knowledge, and provides recommendations for moving forward.
AB - Acute myocardial infarction (MI) can occur from increased myocardial oxygen demand and/or reduced supply in the absence of acute atherothrombotic plaque disruption; a condition called type 2 myocardial infarction (T2MI). As with any MI subtype, there must be clinical evidence of myocardial ischemia to make the diagnosis. This condition is increasingly diagnosed due to the increasing sensitivity of cardiac troponin assays and is associated with adverse short-term and long-term prognoses. Limited data exist defining optimal management strategies because T2MI is a heterogeneous entity with varying etiologies and triggers. Thus, these patients require individualized care. A major barrier is the absence of a uniform definition that can be operationalized with high reproducibility. This document provides a synthesis of the data about T2MI to assist clinicians’ understanding of its pathobiology, when to deploy the diagnosis, and its associated treatments. It also clarifies prognosis, identifies gaps in knowledge, and provides recommendations for moving forward.
KW - Universal Definition of Myocardial Infarction
KW - acute myocardial infarction
KW - cardiac troponin
KW - myocardial injury
KW - type 2 myocardial infarction
UR - http://www.scopus.com/inward/record.url?scp=85063676293&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85063676293&partnerID=8YFLogxK
U2 - 10.1016/j.jacc.2019.02.018
DO - 10.1016/j.jacc.2019.02.018
M3 - Review article
C2 - 30975302
AN - SCOPUS:85063676293
VL - 73
SP - 1846
EP - 1860
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
SN - 0735-1097
IS - 14
ER -