Type 2 versus type 1 myocardial infarction: a comparison of clinical characteristics and outcomes with a meta-analysis of observational studies
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...
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Published in | Cardiovascular diagnosis and therapy Vol. 7; no. 4; pp. 348 - 358 |
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Main Authors | , , , , |
Format | Journal Article |
Language | English |
Published |
China (Republic : 1949- )
AME Publishing Company
01.08.2017
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Subjects | |
Online Access | Get full text |
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Summary: | 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.
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.
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%
4.7%, P<0.00001), 30-day (17.6%
5.3%, P<0.00001) and 1-yr mortality (27%
13%, P<0.00001), as well as higher 30-day major adverse cardiovascular events (20%
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%).
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. |
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Bibliography: | Contributions: (I) Concept and design: S Gupta, SR Vaidya, S Arora; (II) Administrative support: none; (III) Provision of study material or patients: SR Vaidya; (IV) Collection and assembly of data: S Gupta, SR Vaidya, S Arora, SR Devarapally, A Bahekar; (V) Data analysis and interpretation: S Gupta, SR Vaidya; (VI) Manuscript writing: all authors; (VII) Final approval of manuscript: all authors. |
ISSN: | 2223-3652 2223-3660 |
DOI: | 10.21037/cdt.2017.03.21 |