BACKGROUND: WHO has played a leading role in the formulation and promulgation of standard criteria for the diagnosis of coronary heart disease and myocardial infarction since early 1970s. METHODS: The revised definition takes into consideration the following: well-resourced settings can use the ESC/ACC/AHA/WHF definition, which has new biomarkers as a compulsory feature; in resource-constrained settings, a typical biomarker pattern cannot be made a compulsory feature as the necessary assays may not be available; the definition must also have provision for diagnosing non-fatal events with incomplete information on cardiac biomarkers and the ECG; to facilitate epidemiologic monitoring definition must recognize fatal events with incomplete or no information on cardiac biomarkers and/or ECG and/or autopsy and/or coronary angiography. RESULTS: Category A definition is the same as ESC/ACC/AHA/WHF definition of MI, and can be applied to settings with no resource constraints. Category B definition of MI is to be applied whenever there is incomplete information on cardiac bio-markers together with symptoms of ischaemia and the development of unequivocal pathological Q waves. Category C definition (probable MI) is to be applied when individuals with MI may not satisfy Category A or B definitions because of delayed access to medical services and/or unavailability of electrocardiography and/or laboratory assay of cardiac biomarkers. In these situations, the term probable MI should be used when there is either ECG changes suggestive of MI or incomplete information on cardiac biomarkers in a person with symptoms of ischaemia with no evidence of a non-coronary reason. CONCLUSIONS: This article presents the 2008-09 revision of the World Health Organization (WHO) definition of myocardial infarction (MI) developed at a WHO expert consultation.
BACKGROUND: WHO has played a leading role in the formulation and promulgation of standard criteria for the diagnosis of coronary heart disease and myocardial infarction since early 1970s. METHODS: The revised definition takes into consideration the following: well-resourced settings can use the ESC/ACC/AHA/WHF definition, which has new biomarkers as a compulsory feature; in resource-constrained settings, a typical biomarker pattern cannot be made a compulsory feature as the necessary assays may not be available; the definition must also have provision for diagnosing non-fatal events with incomplete information on cardiac biomarkers and the ECG; to facilitate epidemiologic monitoring definition must recognize fatal events with incomplete or no information on cardiac biomarkers and/or ECG and/or autopsy and/or coronary angiography. RESULTS: Category A definition is the same as ESC/ACC/AHA/WHF definition of MI, and can be applied to settings with no resource constraints. Category B definition of MI is to be applied whenever there is incomplete information on cardiac bio-markers together with symptoms of ischaemia and the development of unequivocal pathological Q waves. Category C definition (probable MI) is to be applied when individuals with MI may not satisfy Category A or B definitions because of delayed access to medical services and/or unavailability of electrocardiography and/or laboratory assay of cardiac biomarkers. In these situations, the term probable MI should be used when there is either ECG changes suggestive of MI or incomplete information on cardiac biomarkers in a person with symptoms of ischaemia with no evidence of a non-coronary reason. CONCLUSIONS: This article presents the 2008-09 revision of the World Health Organization (WHO) definition of myocardial infarction (MI) developed at a WHO expert consultation.
Authors: Shanshan Li; Stephanie E Chiuve; Alan Flint; Jennifer K Pai; John P Forman; Frank B Hu; Walter C Willett; Kenneth J Mukamal; Eric B Rimm Journal: JAMA Intern Med Date: 2013-10-28 Impact factor: 21.873
Authors: Hyuk-Jae Chang; Fay Y Lin; Sang-Eun Lee; Daniele Andreini; Jeroen Bax; Filippo Cademartiri; Kavitha Chinnaiyan; Benjamin J W Chow; Edoardo Conte; Ricardo C Cury; Gudrun Feuchtner; Martin Hadamitzky; Yong-Jin Kim; Jonathon Leipsic; Erica Maffei; Hugo Marques; Fabian Plank; Gianluca Pontone; Gilbert L Raff; Alexander R van Rosendael; Todd C Villines; Harald G Weirich; Subhi J Al'Aref; Lohendran Baskaran; Iksung Cho; Ibrahim Danad; Donghee Han; Ran Heo; Ji Hyun Lee; Asim Rivzi; Wijnand J Stuijfzand; Heidi Gransar; Yao Lu; Ji Min Sung; Hyung-Bok Park; Daniel S Berman; Matthew J Budoff; Habib Samady; Leslee J Shaw; Peter H Stone; Renu Virmani; Jagat Narula; James K Min Journal: J Am Coll Cardiol Date: 2018-06-05 Impact factor: 24.094
Authors: Kristian Thygesen; Joseph S Alpert; Allan S Jaffe; Maarten L Simoons; Bernard R Chaitman; Harvey D White Journal: Nat Rev Cardiol Date: 2012-08-25 Impact factor: 32.419