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Application of the ...
Application of the Universal Definition of Myocardial Infarction in Clinical Practice in Scotland and Sweden
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- Taggart, Caelan (författare)
- Univ Edinburgh, British Heart Fdn Ctr Cardiovasc Sci, Chancellors Bldg, Edinburgh EH16 4SU, Midlothian, Scotland.
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- Roos, Andreas (författare)
- Karolinska Univ Hosp, Dept Emergency & Reparat Med, Stockholm, Sweden.;Karolinska Inst, Dept Med, Clin Epidemiol Div, Stockholm, Sweden.
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- Kadesjö, Erik (författare)
- Karolinska Univ Hosp, Dept Emergency & Reparat Med, Stockholm, Sweden.;Karolinska Inst, Dept Med, Stockholm, Sweden.
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- Anand, Atul (författare)
- Univ Edinburgh, British Heart Fdn Ctr Cardiovasc Sci, Chancellors Bldg, Edinburgh EH16 4SU, Midlothian, Scotland.
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- Li, Ziwen (författare)
- Univ Edinburgh, British Heart Fdn Ctr Cardiovasc Sci, Chancellors Bldg, Edinburgh EH16 4SU, Midlothian, Scotland.
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- Doudesis, Dimitrios (författare)
- Univ Edinburgh, British Heart Fdn Ctr Cardiovasc Sci, Chancellors Bldg, Edinburgh EH16 4SU, Midlothian, Scotland.
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- Lee, Kuan Ken (författare)
- Univ Edinburgh, British Heart Fdn Ctr Cardiovasc Sci, Chancellors Bldg, Edinburgh EH16 4SU, Midlothian, Scotland.
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- Bularga, Anda (författare)
- Univ Edinburgh, British Heart Fdn Ctr Cardiovasc Sci, Chancellors Bldg, Edinburgh EH16 4SU, Midlothian, Scotland.
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- Wereski, Ryan (författare)
- Univ Edinburgh, British Heart Fdn Ctr Cardiovasc Sci, Chancellors Bldg, Edinburgh EH16 4SU, Midlothian, Scotland.
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- Lowry, Matthew T. H. (författare)
- Univ Edinburgh, British Heart Fdn Ctr Cardiovasc Sci, Chancellors Bldg, Edinburgh EH16 4SU, Midlothian, Scotland.
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- Chapman, Andrew R. (författare)
- Univ Edinburgh, British Heart Fdn Ctr Cardiovasc Sci, Chancellors Bldg, Edinburgh EH16 4SU, Midlothian, Scotland.
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- Ferry, Amy V. (författare)
- Univ Edinburgh, British Heart Fdn Ctr Cardiovasc Sci, Chancellors Bldg, Edinburgh EH16 4SU, Midlothian, Scotland.
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- Shah, Anoop S. V. (författare)
- London Sch Hyg & Trop Med, Dept Noncommunicable Dis Epidemiol, London, England.
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- Gard, Anton, 1985- (författare)
- Uppsala universitet,Kardiologi
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- Lindahl, Bertil, 1957- (författare)
- Uppsala universitet,Kardiologi
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- Edgren, Gustaf (författare)
- Karolinska Inst, Dept Med, Clin Epidemiol Div, Stockholm, Sweden.;Soder Sjukhuset, Dept Cardiol, Stockholm, Sweden.
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- Mills, Nicholas L. (författare)
- Univ Edinburgh, British Heart Fdn Ctr Cardiovasc Sci, Chancellors Bldg, Edinburgh EH16 4SU, Midlothian, Scotland.;Univ Edinburgh, Usher Inst, Edinburgh, Midlothian, Scotland.
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- Kimenai, Dorien M. (författare)
- Univ Edinburgh, British Heart Fdn Ctr Cardiovasc Sci, Chancellors Bldg, Edinburgh EH16 4SU, Midlothian, Scotland.
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Univ Edinburgh, British Heart Fdn Ctr Cardiovasc Sci, Chancellors Bldg, Edinburgh EH16 4SU, Midlothian, Scotland Karolinska Univ Hosp, Dept Emergency & Reparat Med, Stockholm, Sweden.;Karolinska Inst, Dept Med, Clin Epidemiol Div, Stockholm, Sweden. (creator_code:org_t)
- American Medical Association (AMA), 2024
- 2024
- Engelska.
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Ingår i: JAMA Network Open. - : American Medical Association (AMA). - 2574-3805. ; 7:4
- Relaterad länk:
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https://doi.org/10.1...
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https://uu.diva-port... (primary) (Raw object)
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- Importance: Whether the diagnostic classifications proposed by the universal definition of myocardial infarction (MI) to identify type 1 MI due to atherothrombosis and type 2 MI due to myocardial oxygen supply-demand imbalance have been applied consistently in clinical practice is unknown.Objective: To evaluate the application of the universal definition of MI in consecutive patients with possible MI across 2 health care systems.Design, Setting, and Participants: This cohort study used data from 2 prospective cohorts enrolling consecutive patients with possible MI in Scotland (2013-2016) and Sweden (2011-2014) to assess accuracy of clinical diagnosis of MI recorded in hospital records for patients with an adjudicated diagnosis of type 1 or type 2 MI. Data were analyzed from August 2022 to February 2023.Main Outcomes and Measures: The main outcome was the proportion of patients with a clinical diagnosis of MI recorded in the hospital records who had type 1 or type 2 MI, adjudicated by an independent panel according to the universal definition. Characteristics and risk of subsequent MI or cardiovascular death at 1 year were compared.Results: A total of 50 356 patients were assessed. The cohort from Scotland included 28 783 (15 562 men [54%]; mean [SD] age, 60 [17] years), and the cohort from Sweden included 21 573 (11 110 men [51%]; mean [SD] age, 56 [17] years) patients. In Scotland, a clinical diagnosis of MI was recorded in 2506 of 3187 patients with an adjudicated diagnosis of type 1 MI (79%) and 122 of 716 patients with an adjudicated diagnosis of type 2 MI (17%). Similar findings were observed in Sweden, with 970 of 1111 patients with adjudicated diagnosis of type 1 MI (87%) and 57 of 251 patients with adjudicated diagnosis of type 2 MI (23%) receiving a clinical diagnosis of MI. Patients with an adjudicated diagnosis of type 1 MI without a clinical diagnosis were more likely to be women (eg, 336 women [49%] vs 909 women [36%] in Scotland; P < .001) and older (mean [SD] age, 71 [14] v 67 [14] years in Scotland, P < .001) and, when adjusting for competing risk from noncardiovascular death, were at similar or increased risk of subsequent MI or cardiovascular death compared with patients with a clinical diagnosis of MI (eg, 29% vs 18% in Scotland; P < .001).Conclusions and Relevance: In this cohort study, the universal definition of MI was not consistently applied in clinical practice, with a minority of patients with type 2 MI identified, and type 1 MI underrecognized in women and older persons, suggesting uncertainty remains regarding the diagnostic criteria or value of the classification.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
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Taggart, Caelan
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Roos, Andreas
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Kadesjö, Erik
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Anand, Atul
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Li, Ziwen
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Doudesis, Dimitr ...
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Lee, Kuan Ken
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Bularga, Anda
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Wereski, Ryan
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Lowry, Matthew T ...
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Chapman, Andrew ...
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Ferry, Amy V.
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Shah, Anoop S. V ...
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Gard, Anton, 198 ...
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Lindahl, Bertil, ...
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Edgren, Gustaf
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Mills, Nicholas ...
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Kimenai, Dorien ...
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Uppsala universitet