Affiliation:
1. Federal State Budgetary Educational Institution of Higher Education “Kemerovo State Medical University” of the Ministry of Health of the Russian Federation
2. Federal State Budgetary Educational Institution of Higher Education “Kemerovo State Medical University” of the Ministry of Health of the Russian Federation;
Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Diseases”
3. Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Diseases”
Abstract
HighlightsPatients with type 2 myocardial infarction have a more favorable course of the disease in the long-term postinfarction period compared with patients with type 1 myocardial infarction. We have determined the differences in clinical and anamnestic characteristics of patients with type 1 and type 2 MI. AbstractAim. To determine the prevalence of patients with type 2 myocardial infarction (MI) and their features in clinical practice.Methods. The prospective study involved 204 patients with acute coronary syndrome (ACS). The inclusion criteria were as follows: diagnosed ACS at admission followed by a confirmed MI during the inpatient period according to the Fourth Universal definition of MI. The following parameters were analyzed: anthropometric parameters, clinical and anamnestic characteristics, results of laboratory tests, biochemical markers of myocardial necrosis, results of instrumental diagnostics and coronary angiography. A follow-up telephone survey was carried out a year after ACS, noting the following endpoints: repeated coronary events, death, repeated hospitalizations, adherence to medical recommendations, medication taken by the patient.Results. Type 2 MI was diagnosed in 22 (10.8%) patients. The results of coronary angiography revealed either the absence of coronary artery (CA) stenosis or the presence of stenosis of less than 50% without indications of thrombosis in 16 (72.7%) of those patients. Chronic total occlusion of a non-infarct-related artery was found in 6 (27.3%) patients. Patients with type 2 MI were comparable in age with patients with type 1 MI. The group of patients with type 2 MI included more women (p = 0.029), fewer smokers (p = 0.037) and more cases of atrial fibrillation (AF) (p = 0.003) compared to patients with type 1 MI. The factors that were associated with type 2 MI were as follows: sinus tachycardia in 3 (13.6%) patients, paroxysmal atrial flutter or AF with ventricular tachysystole in 4 patients (18.2%).Conclusion. Patients with type 1 MI presented with a less favorable course of the disease: we noted higher number of recurrent MI and deaths one year after the index event compared with patients with type 2 MI. The group of patients with type 2 MI consisted mostly of women, fewer smokers and patients with dyslipidemia, as well as a more frequent indication of AF compared with patients with type 1 MI.