Coronary disease & ACSCohort study
Incidence, Trends, and Outcomes of Type 2 Myocardial Infarction in a Community Cohort
- Prospective community cohort study
- population-based
- events retrospectively classified by universal definition
Authors' conclusion
There has been an evolution in the type of MI occurring in the community over a decade, with the incidence of T2MI now being similar to T1MI. Mortality after T2MI is higher and driven by early and noncardiovascular death. The provoking mechanism of supply/demand mismatch affects long-term survival.
Study context
- Population
- Olmsted County, Minnesota residents with cardiac troponin T ≥0.01 ng/mL, 2003–2012troponin T ≥0.01 ng/mL
- Participants
- 5,460 participants
- Exposure
- T2MI vs T1MI
- T2MIn = 1,054
- T1MIn = 1,365reference
- Outcome
- Incidence and trends of T2MI; long-term all-cause and CV mortality and recurrent MI
Main finding
As reported in the abstract
Annual incidence (per 100 000 persons), 2003 to 2012 · 2003–2012
| Group | Annual incidence 2003 → 2012 |
|---|---|
| T1MI | 202 to 84 per 100 000 persons (P<0.001) |
| T2MI | 130 to 78 per 100 000 persons (P=0.02) |
Observational data: associations, not effects.
Further findings
Long-term all-cause mortality, T2MI vs T1MI
- Higher in T2MI after adjustment for age and sex, driven by early and noncardiovascular death
- adjusted for age and sex
CV death
- Rates of CV death similar after either type of MI
- HR 0.8 (95% CI 0.7-1.0), P=0.11
Prognosis of T2MI by provoking mechanism
- More favourable prognosis when the principal provoking mechanism was arrhythmia, vs postoperative status, hypotension, anaemia and hypoxia
MI during follow-up after index T2MI · 5 years
- Recurrent T2MI (estimated rate)
- 9.7%
- New T1MI (estimated rate)
- 1.7%
Original publication
Incidence, Trends, and Outcomes of Type 2 Myocardial Infarction in a Community Cohort. Circulation. Published 6 January 2020. doi:10.1161/circulationaha.119.043100
Summarised from the published abstract; every number is checked against it