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Background: Troponin peak (TnP) has been shown to be a marker of the extent of myocardial necrosis in patients with Myocardial Infarction (MI) and a subsequent marker of adverse cardiovascular outcome. The Third Universal Definition of MI categorizes patients into five types. Type 1 MI is defined as MI due to plaque rupture and thrombosis and Type 2 MI refers to a mismatch between myocardial oxygen demand and supply, secondary to a non-cardiac condition. The extent of myocardial necrosis between Type 1 and Type 2 MI has not been evaluated previously.
Methods: Charts for 894 consecutive patients discharged with diagnosis of Non-ST elevation MI (NSTEMI) between July 2013 and June 2014 were reviewed. Patients were classified into Type 1 and Type 2 MI based on The Third Universal Definition. TnP was compared between the two groups using the Wilcoxon-Mann-Whitney test.
Results: Overall, 724 patients met the inclusion criteria for MI per Third Universal Definition with 76.7% were included in Type 1 MI subgroup and 23.3% in Type 2 MI. Median TnP for patients with Type 1 MI was 2.5 (IQR 0.7 – 9.5, max 222), and 1.8 (IQR 0.7 – 4.1, max 49.3) for patients with Type 2 MI. TnP was significantly higher among Type 1 MI patients compared to Type 2, p=0.007 (Figure 1).
Conclusions: A higher Troponin peak for Type 1 MI suggests a higher degree of myocardial necrosis when compared to Type 2 MI.
Figure 1. Normal density of peak troponin levels, stratified across patients with Type 1 MI (solid) and Type 2 MI (dashed).
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Novel Developments in Acute Coronary Syndromes
Abstract Category: 15. Interventional Cardiology: ACS/AMI/Hemodynamics and Pharmacology
Presentation Number: 1194-163
- 2017 American College of Cardiology Foundation