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The effect of the 2012 European Society of Cardiology/American Heart Association Universal Definition of myocardial infarction (MI) on event rates in clinical studies has not been well characterized.
695 subjects hospitalized for acute coronary syndrome (ACS) were enrolled in the Prescription Use, Lifestyle, & Stress Evaluation study. Deaths and hospitalizations during a 12-month period post-hospital discharge were reviewed. We compared the number of MI's according to a definition based on a troponin level above the clinical decision limit for specific assays, versus the 2012 Universal Definition of MI. The composite outcome of death / MI / urgent revascularization was also compared.
The mean age was 63.2 years, and 33.5% were female. There were 24 (3.5%) deaths. The number of MI's doubled with the application of the 2012 Universal Definition (29 [4.2%] to 63 [9.1%]). There was also an increase in the composite outcome of death / MI / urgent revascularization, from 89 (12.3%) to 107 (15.4%). Of the 34 additional MI's identified by the 2012 Universal Definition, 15 (41.2%) were type 1 and 16 (51.6%) were type 2.
Application of the 2012 Universal Definition doubled the number of MIs identified and modestly increased our composite outcome of death / MI / urgent revascularization. These results have important implications for planning of future trials in post-ACS patients.
Poster Sessions, Expo North
Saturday, March 09, 2013, 3:45 p.m.-4:30 p.m.
Session Title: STEMI Topics
Abstract Category: 1. Acute Coronary Syndromes: Clinical
Presentation Number: 1171-204
- 2013 American College of Cardiology Foundation