Type 2 myocardial infarction: the potential for early detection

Abstract

Aim. To evaluate the potential of using factors associated with type 2 myocardial infarction (MI) for its early diagnosis.Material and methods. This prospective study included 204 patients diagnosed with acute coronary syndrome (ACS). At the time of admission, each patient underwent standard examinations for ACS patients. The 1-year stage consisted of telephone survey of patients on the course of long-term postinfarction period. There were following endpoints: death, recurrent coronary events and hospitalization.Result. Patients with type 2 MI accounted for 10,8% (n=22) of the entire analyzed sample. A model for prehospital diagnosis of probable type 2 MI has been developed. The model included clinical and history data that allow to suggest the type 2 MI course without invasive and laboratory studies. The model included signs (body mass index ≥35, kg/m2, atrial fibrillation+Killip I, hemoglobin <110 g/l within 1 year before MI, chronic obstructive pulmonary disease), the most common in type 2 MI patients according to own data and previous studies.Conclusion. A model of prehospital clinical assessment of MI risk has been developed for making a preliminary diagnosis and forming different patient streams at the admission stage for the final verification of the diagnosis.