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• TITLE: Prognostic implications of type 2 myocardial infarctions

  AUTHORS: Hazim El-Haddad, Elijah Robinson, Katrina Swett, Gretchen L. Wells

  KEYWORDS: Type 2 Myocardial Infarction; Postoperative Myocardial Infarction; Troponin; Sepsis

  JOURNAL NAME: World Journal of Cardiovascular Diseases, Vol.2 No.4, October 30, 2012

  ABSTRACT: Purpose: A type 2 myocardial infarction (MI) is due to ischemia from increased oxygen demand or decreased supply. It is not an infrequent complication following non-cardiac surgery or in the setting of acute medical illness. The purpose of this study was to determine whether type 2 MIs had a worse prognosis than a type 1 MI. Methods: The hospital database of a large terti-ary-level academic medical center was queried for all patients with a troponin I ≥ 1.6 ng/mL during a one-year period. The outcomes of patients with a type 2 MI were compared to those with a type 1 MI. Results: This retrospective study found that a type 2 MI is more lethal than the usual type 1 MI, particularly among women and the elderly. There was no statistical difference in outcomes between those that occurred in the post-operative setting compared to those that occurred in the setting of acute medical illness. Conclusions: Type 2 MIs are common and are associated with increased mortality, as compared with type 1 MIs. To date, no guidelines exist for the management of this type of MI. Further research into underlying mechanisms resulting in type 2 MI as well as potential treatment strategies is needed.