scholarly journals Elements of the fourth universal definition used in the diagnosis of acute myocardial infarction

2021 ◽  
Vol 14 (6) ◽  
pp. 175-179
Author(s):  
Krishna Modi ◽  
James McCord ◽  
Michael Hudson ◽  
Michele Moyer ◽  
Gordon Jacobsen ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Universal Definition

P5502Comparison of clinical characteristics and prognosis between non-octogenarians and octogenarians with cardiac troponin positive acute myocardial infarction

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
T Soeda ◽  
M Ishihara ◽  
F Fujino ◽  
H Ogawa ◽  
K Nakao ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Hospital Mortality ◽  
Cardiac Troponin ◽  
Clinical Characteristics ◽  
St Segment Elevation ◽  
The Poor ◽  
St Segment ◽  
Universal Definition ◽  
Multicenter Registry

Abstract Background Cardiac troponin (cTn) is the preferred biomarker for the diagnosis of acute myocardial infarction (AMI). Octogenarians who presented cTn positive AMI are not usually recruited in clinical trials. Therefore, their clinical characteristics and prognosis are rarely investigated. Objective To study the characteristics and prognosis in octogenarians who presented cTn positive AMI. Methods and results The Japanese registry of acute Myocardial INfarction diagnosed by Universal dEfiniTion (J-MINUET) is a prospective and multicenter registry. A total of 3,283 consecutive AMI patients who were diagnosed by cTn-based criteria were included. The patients were divided into non-octogenarians (n=2,593) and octogenarians (n=690). Compared with non- octogenarians, octogenarians showed significantly lower incidence of diabetes mellitus (37.6% and 31.9%, p=0.006) and dyslipidemia (53.6% and 45.6%, p<0.001), and significantly higher incidence of hypertension (64.1% and 75.3%, p<0.001) and chronic kidney disease (38.7% and 68.7%, p<0.001). Octogenarians showed significantly longer onset to door time (p<0.001) and longer door to device time (p<0.001). Though, compared with non-octogenarians, octogenarians showed lower peak CK (2,506 and 1,926, p<0.001), LVEF was significantly lower in octogenarians (54.6% and 52.6%, p=0.005). The presentation of AMI was different between the two group. The incidence of ST-segment elevation MI (STEMI) was 70.7% in non-octogenarians and 62.0% in octogenarians. Non-STEMI with CK elevation and without CK elevation were 16.2% and 13.1% in non- octogenarians, and 20.9% and 17.1% in octogenarians. In-hospital mortality was higher in octogenarians (4.7% and 13.2%, P<0.001). Especially, octogenarians with STEMI and non-STEMI with CK elevation showed the highest in-hospital mortality. And octogenarians without CK elevation showed similar in hospital mortality with non-octogenarians with STEMI (Figure). Conclusions J-MINUET showed the poor prognosis of octogenarians who were diagnosed as AMI based on cTn. Acknowledgement/Funding None

Abstract 17382: Gender Difference in Presentation, Management and Outcome of Patients With Acute Myocardial Infarction: A Sub-analysis of J-MINUET Study

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Yasuharu Nakama ◽  
Masaharu Ishihara ◽  
Masashi Fujino ◽  
Hisao Ogawa ◽  
Koichi Nakao ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Gender Difference ◽  
Hospital Mortality ◽  
Current Smoking ◽  
Killip Class ◽  
Universal Definition ◽  
The Impact

Purpose: Several studies have reported gender difference in presentation, management and outcome in patients with acute myocardial infarction (AMI). In this study, we focused the impact of age on gender difference in mortality after AMI. Methods: Between July 2012 and March 2014, 3283 patients were admitted to the 28 hospitals participating to the J-MINUET group within 48 hours after the onset of AMI. AMI was diagnosed by universal definition (type 1 or type 2). Patients were divided into 5 strata according to their age: those with age <55 years, 55-64 years, 65-74 years, 75-84 years and ≥85 years. Results: There were 813 women (24.8%). Women were significantly older than men (74.5±11.8 years vs 66.6±12.3 years, P<0.001). Women had longer time from onset to admission, more NSTEMI, atypical symptom other than chest pain, Killip class ≥2, CKD and type 2 MI. They also had less diabetes and current smoking habits. Although most of the patients received urgent angiography (93.1%), it was less frequent in women (90.4% vs 94.0%, P<0.001). Among patients who underwent primary PCI (85.1%), achievement of final TIMI-3 flow was similar (91.2% vs 92.0%, P=0.53). In-hospital mortality was significantly higher in women than men (9.6% vs 5.5%, P<0.001). When patients were stratified according to their age, there was a liner increase in the prevalence of women as age advanced: 10.6% in <55 years, 15.1% in 55-64 years, 19.8% in 65-74 years, 35.6% in 75-84 years and 53.6% in ≥85 years (P<0.001). There was no significant gender difference in mortality in each stratum (Figure). Multivariate analysis showed that women was no more an independent predictor of death after adjusting age (OR 1.29, 95%CI 0.95-1.75, P=0.10), or age and other variables (OR 1.19, 95%CI 0.79-1.76, P=0.40). Conclusions: Women had higher in-hospital mortality than men after AMI even in the contemporary troponin era. However, their high mortality was mostly explained by their advanced age.

scholarly journals ST2 DI INFARK MIOKARD AKUT

2016 ◽  
Vol 20 (3) ◽  
pp. 176
Author(s):  
Hery Priyanto ◽  
Jusak Nugraha ◽  
SP Edijanto
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Serum Levels ◽  
Diagnostic Value ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Clinical Criteria ◽  
Diagnosis And Prognosis ◽  
Main Complaint ◽  
Universal Definition

Acute Myocardial Infarction (AMI) is a major problem threatening Indonesian inhabitants as well as in many countries. Each year AMI patients are increasing. ST2 is a novel cardiac marker for the diagnosis and prognosis of acute myocardial infarction. The purpose of this study was to know and find the diagnostic value of ST2 serum in patients with AMI. This cross sectional study was conducted on 46 patients who had chest pain as the main complaint in the Emergency Department, Dr. Soetomo Hospital, Surabaya between April 20 to July 20, 2013. The sera were examined for ST2, cTn-T, the diagnostic value was determined using the acute myocardial infarction clinical criteria according to the Universal Definition of Myocardial Infarction (2007) as the gold standard. The results of ST2 serum levels measurement showed a sensitivity of 83% and specificity of 70% at a cut-off value of ST2 16.64 ng/mL and AUC 0.878, p=0.000. The concordance examination between using cTn-T levels and ST2 was 48.1%. A significanct correlation was obtained with a correlation coefficient r=0.489, p=0.001 between the levels of cTn-T and ST2. Based on this study, the ST2 serum levels can be used for screeningto aid the diagnosis of acute myocardial infarction. However, there is a weak correlation and concordance between cTn-T with ST2. Thus, the researchers need a further study to determine the diagnostic value of ST2 for the detection of acute myocardial infarction.

Registry of Acute Myocardial Infarction. REGION-MI – Russian Registry of Acute Myocardial Infarction

Kardiologiia ◽  
2021 ◽  
Vol 61 (6) ◽  
pp. 41-51
Author(s):  
S. A. Boytsov ◽  
R. M. Shakhnovich ◽  
A. D. Erlikh ◽  
S. N. Tereschenko ◽  
N. G. Kukava ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
St Segment Elevation ◽  
St Segment ◽  
Icd 10 ◽  
Universal Definition ◽  
One Year ◽  
Real Picture ◽  
European Society Of Cardiology

Aim      To study features of diagnosis and treatment of acute myocardial infarction (AMI) in Russian hospitals, results of the treatment, and early and late outcomes (6 and 12 months after AMI diagnosis); to evaluate the consistence of the treatment with clinical guidelines; and to evaluate patients’ compliance with the treatment.Material and methods  The program was designed for 3 years, including 24 months for recruitment of patients to the study. The study will include 10, 000 patients hospitalized with a confirmed diagnosis (I21 according to ICD-10) of ST segment elevation acute myocardial infarction (MI) (STEMI) or non-ST segment elevation MI (NSTEMI) based on criteria of the European Society of Cardiology Guidelines on Forth Universal Definition of Myocardial Infarction (2018). The follow-up period was divided into three stages: observation during the stay in the hospital and at 6 and 12 months following inclusion into the registry. The primary endpoint included cardiac death, nonfatal MI during the hospitalization and after one-year follow-up. Secondary endpoints were 6-months and one-year incidence of repeated MI, heart failure, ischemic stroke, clinically significant hemorrhage, unscheduled revascularization after discharge from the hospital, and the proportion of patients who continue on statins, antiplatelet drugs, and drugs of other groups for 6 months and 1 year.Results The inclusion of patients into the registry started in 2020 and will continue for 24 months. By the time of the article publication (June, 2021), more than 2,000 patients will be included.Conclusion      REGION-MI (Russian rEGIstry Of acute myocardial iNfarction) is a multicenter, retrospective and prospective observational cohort study that excludes any interference with the clinical practice. Results of the registry will help to analyze a real picture of medical care provided to patients with myocardial infarction and to schedule ways to improve the situation.

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