Sonu Gupta1, Satyanarayana R Vaidya1, Sameer Arora1,2, Amol Bahekar3, Santhosh R Devarapally3,4. 1. Department of Internal Medicine, Cape Fear Valley Medical Center, Fayetteville, NC, USA. 2. Division of Cardiology, University of North Carolina, Chapel Hill, NC, USA. 3. Division of Cardiology, Cape Fear Valley Medical Center, Fayetteville, NC, USA. 4. Division of Cardiology, New York Methodist Hospital, Weill Cornell Medical College, NY, USA.
Abstract
BACKGROUND: Type 2 myocardial infarction (MI) is an imbalance between myocardial oxygen demand and supply, leading to myocardial ischemia. It is not due to plaque rupture, and is usually caused by a condition other than coronary artery disease (CAD). However, limited data are available comparing the prevalence of traditional coronary risk factors and mortality between type 1 and type 2 MI. We hypothesize that type 2 MI carries a higher mortality than type 1. METHODS: We searched the databases of PubMed, EMBASE, CENTRAL, and MEDLINE for studies comparing type 1 MI with type 2 MI. The baseline variables were compared in each cohort. Summary risk ratios and 95% confidence intervals were calculated using the random effects model to compare mortality between the two groups. RESULTS: The included studies yielded 25,872 patients of whom 2,683 (10%) had type 2 MI. Compared to the type 1 cohort, the type 2 cohort had significantly higher inpatient (15% vs. 4.7%, P<0.00001), 30-day (17.6% vs. 5.3%, P<0.00001) and 1-yr mortality (27% vs. 13%, P<0.00001), as well as higher 30-day major adverse cardiovascular events (20% vs. 9%, P<0.0001). Operative stress (20%) was the most common trigger of type 2 MI, followed by sepsis (19%), arrhythmia (18.63%), heart failure (15%), and anemia (12%). CONCLUSIONS: Type 2 MI is a common entity and is more common in females, older age groups, and in patients with multiple comorbidities: it also tends to result in higher mortality.
BACKGROUND: Type 2 myocardial infarction (MI) is an imbalance between myocardial oxygen demand and supply, leading to myocardial ischemia. It is not due to plaque rupture, and is usually caused by a condition other than coronary artery disease (CAD). However, limited data are available comparing the prevalence of traditional coronary risk factors and mortality between type 1 and type 2 MI. We hypothesize that type 2 MI carries a higher mortality than type 1. METHODS: We searched the databases of PubMed, EMBASE, CENTRAL, and MEDLINE for studies comparing type 1 MI with type 2 MI. The baseline variables were compared in each cohort. Summary risk ratios and 95% confidence intervals were calculated using the random effects model to compare mortality between the two groups. RESULTS: The included studies yielded 25,872 patients of whom 2,683 (10%) had type 2 MI. Compared to the type 1 cohort, the type 2 cohort had significantly higher inpatient (15% vs. 4.7%, P<0.00001), 30-day (17.6% vs. 5.3%, P<0.00001) and 1-yr mortality (27% vs. 13%, P<0.00001), as well as higher 30-day major adverse cardiovascular events (20% vs. 9%, P<0.0001). Operative stress (20%) was the most common trigger of type 2 MI, followed by sepsis (19%), arrhythmia (18.63%), heart failure (15%), and anemia (12%). CONCLUSIONS: Type 2 MI is a common entity and is more common in females, older age groups, and in patients with multiple comorbidities: it also tends to result in higher mortality.
Entities:
Keywords:
Type-1 MI; type-2 MI; universal definition of MI
Authors: Shanthi Mendis; Kristian Thygesen; Kari Kuulasmaa; Simona Giampaoli; Markku Mähönen; Kathleen Ngu Blackett; Liu Lisheng Journal: Int J Epidemiol Date: 2010-10-05 Impact factor: 7.196
Authors: Kristian Thygesen; Joseph S Alpert; Allan S Jaffe; Maarten L Simoons; Bernard R Chaitman; Harvey D White; Kristian Thygesen; Joseph S Alpert; Harvey D White; Allan S Jaffe; Hugo A Katus; Fred S Apple; Bertil Lindahl; David A Morrow; Bernard R Chaitman; Peter M Clemmensen; Per Johanson; Hanoch Hod; Richard Underwood; Jeroen J Bax; Jeroen J Bonow; Fausto Pinto; Raymond J Gibbons; Keith A Fox; Dan Atar; L Kristin Newby; Marcello Galvani; Christian W Hamm; Barry F Uretsky; Ph Gabriel Steg; William Wijns; Jean-Pierre Bassand; Phillippe Menasche; Jan Ravkilde; E Magnus Ohman; Elliott M Antman; Lars C Wallentin; Paul W Armstrong; Maarten L Simoons; James L Januzzi; Markku S Nieminen; Mihai Gheorghiade; Gerasimos Filippatos; Russell V Luepker; Stephen P Fortmann; Wayne D Rosamond; Dan Levy; David Wood; Sidney C Smith; Dayi Hu; Jose-Luis Lopez-Sendon; Rose Marie Robertson; Douglas Weaver; Michal Tendera; Alfred A Bove; Alexander N Parkhomenko; Elena J Vasilieva; Shanti Mendis; Jeroen J Bax; Helmut Baumgartner; Claudio Ceconi; Veronica Dean; Christi Deaton; Robert Fagard; Christian Funck-Brentano; David Hasdai; Arno Hoes; Paulus Kirchhof; Juhani Knuuti; Philippe Kolh; Theresa McDonagh; Cyril Moulin; Bogdan A Popescu; Zeljko Reiner; Udo Sechtem; Per Anton Sirnes; Michal Tendera; Adam Torbicki; Alec Vahanian; Stephan Windecker; Joao Morais; Carlos Aguiar; Wael Almahmeed; David O Arnar; Fabio Barili; Kenneth D Bloch; Ann F Bolger; Hans Erik Botker; Biykem Bozkurt; Raffaele Bugiardini; Christopher Cannon; James de Lemos; Franz R Eberli; Edgardo Escobar; Mark Hlatky; Stefan James; Karl B Kern; David J Moliterno; Christian Mueller; Aleksandar N Neskovic; Burkert Mathias Pieske; Steven P Schulman; Robert F Storey; Kathryn A Taubert; Pascal Vranckx; Daniel R Wagner Journal: J Am Coll Cardiol Date: 2012-09-05 Impact factor: 24.094
Authors: Tomasz Baron; Kristina Hambraeus; Johan Sundström; David Erlinge; Tomas Jernberg; Bertil Lindahl Journal: Heart Date: 2014-10-20 Impact factor: 5.994
Authors: Manuel A Gonzalez; Dana J Eilen; Rana A Marzouq; Christopher P Porterfield; Surovi Hazarika; Summiyah Nasir; Amit A Patel; Karyll De J Gonzalez; Michael B Burris; Mayelin Prieto-Gonzalez; John D Rose; Wayne E Cascio Journal: Cardiovasc Revasc Med Date: 2010-10-20
Authors: Kris G Vargas; Paul M Haller; Bernhard Jäger; Maximilian Tscharre; Ronald K Binder; Christian Mueller; Bertil Lindahl; Kurt Huber Journal: Clin Res Cardiol Date: 2018-12-07 Impact factor: 5.460
Authors: Christoph B Olivier; Hillary Mulder; William R Hiatt; W Schuyler Jones; F Gerry R Fowkes; Frank W Rockhold; Jeffrey S Berger; Iris Baumgartner; Peter Held; Brian G Katona; Lars Norgren; Juuso Blomster; Manesh R Patel; Kenneth W Mahaffey Journal: JAMA Cardiol Date: 2019-01-01 Impact factor: 14.676
Authors: Heidi M Crane; Robin M Nance; Bridget M Whitney; Susan R Heckbert; Matthew Budoff; Kevin High; Alan Landay; Matthew Feinstein; Richard D Moore; William Christopher Mathews; Katerina Christopoulos; Michael S Saag; Amanda Willig; Joseph J Eron; Mari M Kitahata; Joseph A C Delaney Journal: J Acquir Immune Defic Syndr Date: 2021-02-01 Impact factor: 3.771
Authors: Robert A Wise; Julie A Anderson; Pierre Amarenco; Nicholas J Cowans; Courtney Crim; Martin A Denvir; Camilo R Gomez; Matthew Pa Jones; Andrea Morris; Dennis Niewoehner; Julie C Yates Journal: Clin Trials Date: 2020-05-22 Impact factor: 2.486
Authors: Christopher Reid; Ahmed Alturki; Andrew Yan; Derek So; Dennis Ko; Jean-Francois Tanguay; Amal Bessissow; Shamir Mehta; Shaun Goodman; Thao Huynh Journal: CJC Open Date: 2020-02-24