Comparison between type-2 and type-1 myocardial infarction：clinical features, treatment strategies and outcomes

• Published in: Journal of geriatric cardiology : JGC Vol. 13; no. 1; pp. 15 - 22
• Main Author: Angel Lopez-Cuenca Miriam Gomez-Molina Pedro J Flores-Blanco Marianela Sanchez-Martinez Andrea Garcia-Narbon Ignacio De Las Heras-Gomez Maria J Sainchez-Galian Esther Guerrero-Perez Mariano Valdes Sergio Manzano-Femandez
• Format: Journal Article
• Language: English
• Published: China Department of Internal Medicine, Hospital de la Vega Lorenzo Guirao, Cieza, Spain%Division of Cardiology, University Hospital Virgen de la Arrixaca, School of Medicine, IMIB, Murcia, Spain%Department of Biochemistry, University Hospital Virgen de la Arrixaca, School of Medicine, IMIB, Murcia, Spain 2016; Science Press
• Subjects: Myocardial infarction; Coronary vessels; Follow-up studies
• ISSN: 1671-5411
• DOI: 10.11909/j.issn.1671-5411.2016.01.014

Objective To assess the differences in incidence, clinical features, current treatment strategies and outcome in patients with type-2vs. type-1 acute myocardial infarction （AMI）.Methods We included 824 consecutive patients with a diagnosis of type-1 or type-2 AMI. Dur-ing index hospitalization, clinical features and treatment strategies were collected in detail. At 1-year follow-up, mortality, stroke, non-fatal myocardial infarction and major bleeding were recorded.ResultsType-1 AMI was present in 707 （86%） of the cases while 117 （14%） were classified as type-2. Patients with type-2 AMI were more frequently female and had higher co-morbidities such as diabetes, previous non-ST segment elevation acute coronary syndromes, impaired renal function, anaemia, atrial fibrillation and malignancy. However, preserved left ventricular ejection fraction and normal coronary arteries were more frequently seen, an invasive treatment was less common, and anti-platelet medications, statins and beta-blockers were less prescribed in patients with type-2 AMI. At 1-year follow-up, type-2 AMI was associated with a higher crude mortality risk （HR： 1.75, 95% CI： 1.14-2.68;P = 0.001）, but this association did not remain significant after multivariable adjustment （P = 0.785）. Furthermore, we did not find type-2 AMI to be associated with other clinical outcomes.Conclusions In this real-life population, compared with type-1, type-2 AMI were predominantly women and had more co-morbidities. Invasive treatment strategies and cardioprotective medications were less used in type-2, while the 1-year clinical outcomes were similar.