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Variations on class...
Variations on classification of main types of myocardial infarction : a systematic review and outcome meta-analysis
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Vargas, Kris G (author)
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Haller, Paul M (author)
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Jäger, Bernhard (author)
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Tscharre, Maximilian (author)
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Binder, Ronald K (author)
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Mueller, Christian (author)
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- Lindahl, Bertil, 1957- (author)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Kardiologi,UCR
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Huber, Kurt (author)
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(creator_code:org_t)
- 2018-12-07
- 2019
- English.
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In: Clinical Research in Cardiology. - : Springer. - 1861-0684 .- 1861-0692. ; 108:7, s. 749-762
- Related links:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
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- OBJECTIVE: Classifying myocardial infarction into type 1 (T1MI) or type 2 (T2MI) remains a challenge in clinical practice. We aimed to identify factors contributing to variation in the classifications of MI into type 1 or type 2. In addition, pooled analyses of long-term mortality and reinfarction outcomes were performed.METHODS: We searched Medline, Embase and Web of Science through January 2018 for observational studies or clinical trials classifying patients as either T1MI or T2MI. Studies with baseline characteristics allowing a comparison between both groups were included. Inverse variance random-effects models were used to pool risk ratios (RR).RESULTS: Overall, 93,194 patients from 20 included observational studies were classified as T1MI and 9291 as T2MI; corresponding to 87.9% and 8.8% of all patients diagnosed with MI. Inclusion of ST-elevation MI patients was inconsistent among studies. Coronary angiography was performed in 77.7% and 31.5% of all patients with T1MI and T2MI, respectively. From a subgroup of 11 studies, percutaneous coronary intervention was performed in 79.2% of all patients classified as T1MI (range 44.2-93.0%) and 40.2% of all T2MI patients (range 0-87.5%). A meta-analysis of 6 studies (44,366 in total) on 2-year mortality showed worse outcome among T2MI patients (RR: 1.52, CI 1.07-2.17, P = 0.02; I2 = 92%). Risk of reinfarction at 1.6 years was higher among T2MI patients (RR: 1.68, CI 1.22-2.31, P = 0.001; I2 = 9%).CONCLUSIONS: Classification of T1MI and T2MI varies widely among studies. A standardized approach with clear definitions is needed to avoid misclassification and ensure appropriate patient management.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- Acute coronary syndrome
- Classification
- Type 1 myocardial infarction
- Type 2 myocardial infarction
- Universal definition
Publication and Content Type
- ref (subject category)
- art (subject category)
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