Diagnostic and prognostic impact of new pathophysiology-based categorization of type 1 and type 2 myocardial infarction: data from the French RICO survey
Authors' conclusion
Our large observational multicenter study shows major disparities in mortality according to type of MI and support the relevance of the new MI classification to improve risk classification, taking into account CAD in T2MI.
Study context
- Population
- Consecutive patients hospitalised for acute myocardial infarction (MI) in a French multicentre database (RICO)
- Participants
- 4,573 patients
- Exposure
- T1MI vs T2AMI vs T2BMI under new pathophysiology-based classification
- Outcome
- Classification of MI type
Methodological detailsmulticentre, consecutive patients
- Multicentre
- Consecutive patients
Main finding
As reported in the abstract
- Initially diagnosed T1MI
- 3,710 (81.1%)
- Initially diagnosed T2MI
- 863 (18.9%)
- T2MI reclassified as T1MI
- 96
- Remaining T2MI
- 767
- T2MI undergoing coronary angiography
- 567
- T2AMI among angiographed T2MI
- 68.6%
- T2BMI among angiographed T2MI
- 31.4%
Observational data: associations, not effects.
Further findings
In-hospital outcomes (severe HF, AF or flutter)
- Severe HF worse in T2AMI vs T1MI and T2BMI
- P < 0.001
- AF or flutter worse in T2AMI vs T1MI and T2BMI
- P < 0.001
All-cause and CV mortality · 1 year
- Higher all-cause and CV mortality in T2AMI vs T1MI and T2BMI (Kaplan-Meier)
- P < 0.001
- Type of MI independent predictor of death (multivariate Cox regression)
Safety
Severe bleeding · in-hospital
- Severe bleeding worse in T2AMI vs T1MI and T2BMI
- P < 0.001
Original publication
Diagnostic and prognostic impact of new pathophysiology-based categorization of type 1 and type 2 myocardial infarction: data from the French RICO survey. Am Heart J. Published 11 September 2023. doi:10.
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