TY - JOUR
T1 - Incident Type 2 Myocardial Infarction in a Cohort of Patients Undergoing Coronary or Peripheral Arterial Angiography
AU - Gaggin, Hanna K.
AU - Liu, Yuyin
AU - Lyass, Asya
AU - van Kimmenade, Roland R. J.
AU - Motiwala, Shweta R.
AU - Kelly, Noreen P.
AU - Mallick, Aditi
AU - Gandhi, Parul U.
AU - Ibrahim, Nasrien E.
AU - Simon, Mandy L.
AU - Bhardwaj, Anju
AU - Belcher, Arianna M.
AU - Harisiades, Jamie E.
AU - Massaro, Joseph M.
AU - D'Agostino, Ralph B.
AU - Januzzi, James L.
PY - 2017/1/10
Y1 - 2017/1/10
N2 - BACKGROUND: Despite growing recognition of type 2 myocardial infarction (T2MI; related to supply/demand mismatch), little is known about its risk factors or its association with outcome.METHODS: A single-center cohort of patients undergoing coronary or peripheral angiography with or without intervention was prospectively enrolled and followed for incident type 1 and T2MI, and major adverse cardiovascular events (MACE, a composite of all-cause death, nonfatal myocardial infarction [MI], heart failure, stroke, transient ischemic attack, peripheral arterial complication, and cardiac arrhythmia), as well. T2MI was adjudicated using criteria from the Third Universal Definition of MI. Baseline characteristics, blood samples, and angiography information were obtained. Major end points subsequent to first MI were assessed using landmark analyses to compare the rates of first events only where everyone with a prior history of any MACE before MI were censored and adjusted for follow-up times. Cox proportional hazard models were used for time-to-event analyses with age and sex forced into all models and additional covariates evaluated by using the stepwise option for the selection.RESULTS: One thousand two hundred fifty-one patients were enrolled and followed for a median of 3.4 years. Of these patients, 152 (12.2%) had T2MI during follow-up; T2MI was frequently recurrent. Multivariable predictors of T2MI were older age, lower systolic blood pressure, history of coronary artery disease, heart failure, chronic obstructive pulmonary disease, diabetes mellitus, nitrate use, and elevated concentrations of glucose, N-terminal pro-B type natriuretic peptide, and cystatin C. Patients with T2MI had higher rates of subsequent adverse events than those without T2MI (per 100 person-years: MACE, 53.7 versus 21.1, PCONCLUSIONS: T2MI is common and associated with poor prognosis. Studies evaluating treatment strategies for management of T2MI are needed.
AB - BACKGROUND: Despite growing recognition of type 2 myocardial infarction (T2MI; related to supply/demand mismatch), little is known about its risk factors or its association with outcome.METHODS: A single-center cohort of patients undergoing coronary or peripheral angiography with or without intervention was prospectively enrolled and followed for incident type 1 and T2MI, and major adverse cardiovascular events (MACE, a composite of all-cause death, nonfatal myocardial infarction [MI], heart failure, stroke, transient ischemic attack, peripheral arterial complication, and cardiac arrhythmia), as well. T2MI was adjudicated using criteria from the Third Universal Definition of MI. Baseline characteristics, blood samples, and angiography information were obtained. Major end points subsequent to first MI were assessed using landmark analyses to compare the rates of first events only where everyone with a prior history of any MACE before MI were censored and adjusted for follow-up times. Cox proportional hazard models were used for time-to-event analyses with age and sex forced into all models and additional covariates evaluated by using the stepwise option for the selection.RESULTS: One thousand two hundred fifty-one patients were enrolled and followed for a median of 3.4 years. Of these patients, 152 (12.2%) had T2MI during follow-up; T2MI was frequently recurrent. Multivariable predictors of T2MI were older age, lower systolic blood pressure, history of coronary artery disease, heart failure, chronic obstructive pulmonary disease, diabetes mellitus, nitrate use, and elevated concentrations of glucose, N-terminal pro-B type natriuretic peptide, and cystatin C. Patients with T2MI had higher rates of subsequent adverse events than those without T2MI (per 100 person-years: MACE, 53.7 versus 21.1, PCONCLUSIONS: T2MI is common and associated with poor prognosis. Studies evaluating treatment strategies for management of T2MI are needed.
KW - angiography
KW - supply/demand mismatch
KW - myocardial infarction
KW - prognosis
KW - 3RD UNIVERSAL DEFINITION
KW - OPTIMIZING PLATELET INHIBITION
KW - CRITICALLY-ILL PATIENTS
KW - CLASSIFICATION-SYSTEM
KW - PRASUGREL-THROMBOLYSIS
KW - THERAPEUTIC OUTCOMES
KW - ASSESS IMPROVEMENT
KW - TRIAL
KW - ASSAY
U2 - 10.1161/CIRCULATIONAHA.116.023052
DO - 10.1161/CIRCULATIONAHA.116.023052
M3 - Article
C2 - 27881568
SN - 0009-7322
VL - 135
SP - 116
EP - 127
JO - Circulation
JF - Circulation
IS - 2
ER -