Author + information
- Avinainder Singha,b,
- Bradley Collinsa,b,
- Arman Qamara,b,
- Sanjay Divakarana,b,
- Josh Kleina,b,
- Jon Hainera,b,
- Petr Jarolima,b,
- Ravi Shaha,b,
- Marcelo Di Carlia,b,
- Khurram Nasira,b,
- Deepak Bhatta,b and
- Ron Blanksteina,b
Background: Recent data suggests that patients with Type 2 Myocardial Infarction (T2-MI) have a worse prognosis than previously appreciated. Yet, little is known about the implications of having a T2-MI at a young age.
Methods: Using clinical & billing data, we identified all patients presenting with a first MI at a young age (women < 50; men < 45 years) to two large medical centers over a 16-year period. Type of MI (T2-MI vs. T1-MI & STEMI vs. NSTEMI) was adjudicated by review of medical records. All-cause death was determined from medical records as well as social security death index & was available for all patients. Kaplan-Meier curves were constructed to illustrate survival free of death. Patients with prior known coronary artery disease, myocarditis, or on chronic hemodialysis were excluded.
Results: 1385 patients (mean age 41; 39% women) with a first MI were included in the analysis. The annual mortality rate was 1.7% over a median follow-up of 9 years. Figure B shows that despite having smaller infarcts & younger age, T2-MI patients had a significantly lower survival than T1-MI (HR=3.28, p<.001). When adjusting for age & peak CK-MB, patients with T2-MI had a HR=3.81, p=0.001 for death. The survival of T1-STEMI patients was similar to T1-NSTEMI patients, although STEMI patients had significantly larger infarct sizes, as measured by CK-MB.
Conclusions: Among young patients who experience a first-time MI, those with Type 2 MI have worse long-term prognosis than those who experience either Type 1 STEMI or Type 1 NSTEMI.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Unusual Presentations of ACS
Abstract Category: 2. Acute and Stable Ischemic Heart Disease: Clinical
Presentation Number: 1297-318
- 2017 American College of Cardiology Foundation