Acute Myocardial Infarction: What's in a Name?
Authors: Gautam R. Shroff
Journal: Annals of Internal Medicine (2015)

Ideas and Opinions17 March 2015Acute Myocardial Infarction: What's in a Name?Gautam R. Shroff, MB, BSGautam R. Shroff, MB, BSFrom Hennepin County Medical Center and University of Minnesota, Minneapolis, Minnesota.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M14-2259 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The development of newer-generation troponin assays has led to remarkable progress in the rapid diagnosis or exclusion of acute myocardial infarction (AMI) (1). With increasing use of higher-sensitivity assays, it has also become evident that troponin level elevations are prevalent in several clinical situations in the absence of an acute coronary syndrome (ACS) (2). Experts have developed a universal classification system to categorize AMI on the basis of differing pathophysiologic mechanisms (3).Type 1 or spontaneous myocardial infarction (T1MI, or ACS in common parlance) is secondary to acute atherosclerotic plaque instability in the coronary bed with intraluminal thrombosis, decreased myocardial ...References1. Bandstein N, Ljung R, Johansson M, Holzmann MJ. Undetectable high-sensitivity cardiac troponin T level in the emergency department and risk of myocardial infarction. J Am Coll Cardiol. 2014;63:2569-78. [PMID: 24694529] doi:10.1016/j.jacc.2014.03.017 CrossrefMedlineGoogle Scholar2. de Lemos JA. Increasingly sensitive assays for cardiac troponins: a review. JAMA. 2013;309:2262-9. [PMID: 23736735] doi:10.1001/jama.2013.5809 CrossrefMedlineGoogle Scholar3. Thygesen K, Alpert JS, Jaffe AS, Simoons ML, Chaitman BR, White HD, et al; Joint ESC/ACCF/AHA/WHF Task Force for the Universal Definition of Myocardial Infarction. Third universal definition of myocardial infarction. Circulation. 2012;126:2020-35. [PMID: 22923432] doi:10.1161/CIR.0b013e31826e1058 CrossrefMedlineGoogle Scholar4. Sandoval Y, Smith SW, Thordsen SE, Apple FS. Supply/demand type 2 myocardial infarction: should we be paying more attention? J Am Coll Cardiol. 2014;63:2079-87. [PMID: 24632278] doi:10.1016/j.jacc.2014.02.541 CrossrefMedlineGoogle Scholar5. Saaby L, Poulsen TS, Hosbond S, Larsen TB, PyndtDiederichsen AC, Hallas J, et al. Classification of myocardial infarction: frequency and features of type 2 myocardial infarction. Am J Med. 2013;126:789-97. [PMID: 23856021] doi:10.1016/j.amjmed.2013.02.029 CrossrefMedlineGoogle Scholar6. Saaby L, Poulsen TS, Diederichsen AC, Hosbond S, Larsen TB, Schmidt H, et al. Mortality rate in type 2 myocardial infarction: observations from an unselected hospital cohort. Am J Med. 2014;127:295-302. [PMID: 24457000] doi:10.1016/j.amjmed.2013.12.020 CrossrefMedlineGoogle Scholar7. Braunwald E, Morrow DA. Unstable angina: is it time for a requiem? Circulation. 2013;127:2452-7. [PMID: 23775194] doi:10.1161/CIRCULATIONAHA.113.001258 CrossrefMedlineGoogle Scholar8. Shroff GR, Heubner BM, Herzog CA. Incidence of acute coronary syndrome in the general Medicare population, 1992 to 2009: a real-world perspective. JAMA Intern Med. 2014;174:1689-90. [PMID: 25111573] doi:10.1001/jamainternmed.2014.3446 CrossrefMedlineGoogle Scholar9. Shroff GR, Solid CA, Herzog CA. Medicare claims for myocardial infarction as primary vs. secondary diagnosis. Int J Cardiol. 2014;182C:412-413. [PMID: 25596467] doi:10.1016/j.ijcard.2014.12.141 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Hennepin County Medical Center and University of Minnesota, Minneapolis, Minnesota.Disclosures: The author has disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M14-2259.Corresponding Author: Gautam R. Shroff, MB, BS, Cardiovascular Division, Hennepin County Medical Center, 701 Park Avenue, Minneapolis, MN 55415; e-mail, [email protected]edu.Author Contributions: Conception and design: G.R. Shroff.Drafting of the article: G.R. Shroff.Critical revision of the article for important intellectual content: G.R. Shroff.Final approval of the article: G.R. Shroff. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoAcute Myocardial Infarction Sukhchain Singh , Amandeep Singh , and Sandeep Khosla Acute Myocardial Infarction Gautam R. Shroff Acute Myocardial Infarction Sukhchain Singh , Amandeep Singh , and Sandeep Khosla Acute Myocardial Infarction Gautam R. Shroff Metrics Cited byBrief Report: Differences in Types of Myocardial Infarctions Among People Aging With HIVDifferentiation of Type 1 and Type 2 Myocardial Infarctions Among HIV-Infected Patients Requires Adjudication Due to Overlap in Risk FactorsIncreased Risk of Myocardial Infarction in HIV-Infected Individuals in North America Compared With the General PopulationTrends in Discharge Claims for Acute Myocardial Infarction among Patients on DialysisTrends in acute myocardial infarction hospitalizations: Are we seeing the whole picture?Acute Myocardial InfarctionSukhchain Singh, MD, Amandeep Singh, MD, and Sandeep Khosla, MD 17 March 2015Volume 162, Issue 6Page: 448-449KeywordsEpidemiologyForecastingHealth careHealth economicsMedicareMyocardial infarctionTroponinUnstable angina ePublished: 17 March 2015 Issue Published: 17 March 2015 Copyright & PermissionsCopyright © 2015 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...