Coronary disease & ACSMeta-analysis
Cardiovascular Risk Across Myocardial Injury and Infarction Categories Using the Universal Definition
- Systematic review and meta-analysis of prospective studies
- individual patient-level data (8 cohorts)
- random-effects
- competing-risk (subdistribution HRs)
Authors' conclusion
All patients with myocardial injury and infarction are at increased risk of future cardiovascular events. However, in type 2 MI, this apparent risk is reduced by a substantially greater competing risk of noncardiovascular death.
Study context
- Population
- Patients with cardiac troponin measured for suspected ACS, diagnoses adjudicated by the Universal Definition17 studies of 9 cohorts
- Participants
- 120,734 patients
- Comparison
- Myocardial injury and myocardial infarction (MI) categories vs no myocardial injury
- Type 1 MIn = 11,298
- Type 2 MIn = 3,609
- Acute myocardial injuryn = 5,864
- Chronic myocardial injuryn = 5,625
- Outcome
- Major adverse cardiovascular events (MACE):
- MI
- CV death
- Follow-up
- Minimum of 1 year
Pooled result
As reported in the abstract
MACE
Each group vs no myocardial injurySubdistribution hazard ratio (95% CI)
Type 1 MII2 = 84%
4.82(3.55–6.57)
Type 2 MII2 = 0%
3.36(2.92–3.86)
Acute myocardial injuryI2 = 59%
3.24(2.41–4.36)
Chronic myocardial injuryI2 = 20%
3.03(2.53–3.62)
Further pooled results
Noncardiovascular death
Original publication
Cardiovascular Risk Across Myocardial Injury and Infarction Categories Using the Universal Definition. J Am Coll Cardiol. Published 10 December 2025. doi:10.1016/j.jacc.2025.11.043
Summarised from the published abstract; every number is checked against it