학술논문
Risk factors for 'microsize' vs. usual myocardial infarctions in the REasons for Geographic and Racial Differences in Stroke (REGARDS) study
ORIGINAL ARTICLE
ORIGINAL ARTICLE
Document Type
Report
Author
Source
European Heart Journal: Quality of Care and Clinical Outcomes. October 2019, Vol. 5 Issue 4, p343, 9 p.
Subject
Language
English
ISSN
2058-5225
Abstract
Introduction The epidemiology of myocardial infarction (MI) is changing in the 21st century, with fewer ST-segment elevation MIs and more non-ST-elevation MIs. However, less attention has been paid to MI [...]
Aims A recently described phenomenon is that of myocardial infarction (MI) events that meet criteria for MI, but that have very low peak troponin elevations, so-called 'microsize MI'. These events are very common and associated with increased risk of all-cause mortality. Our aim is to compare risk factors for microsize MI vs. usual MI events. Methods and results Among 24 470 participants of the Reasons for Geographic and Racial Differences in Stroke (REGARDS) cohort free of coronary heart disease at baseline, heart-related hospitalizations were expert adjudicated for MI using published guidelines. Myocardial infarctions were classified as microsize MI (peak troponin Conclusion The similarities in risk profiles suggest a possible common aetiology and should encourage clinicians to both treat reversible risk factors for microsize MI and to initiate secondary prevention strategies following these events until this emerging clinical entity is better understood. Future studies should further assess the clinical outcomes of these two entities and their effect on future management. Keywords Troponin * Acute coronary syndrome * Risk factors * Microsize MI * Mortality
Aims A recently described phenomenon is that of myocardial infarction (MI) events that meet criteria for MI, but that have very low peak troponin elevations, so-called 'microsize MI'. These events are very common and associated with increased risk of all-cause mortality. Our aim is to compare risk factors for microsize MI vs. usual MI events. Methods and results Among 24 470 participants of the Reasons for Geographic and Racial Differences in Stroke (REGARDS) cohort free of coronary heart disease at baseline, heart-related hospitalizations were expert adjudicated for MI using published guidelines. Myocardial infarctions were classified as microsize MI (peak troponin Conclusion The similarities in risk profiles suggest a possible common aetiology and should encourage clinicians to both treat reversible risk factors for microsize MI and to initiate secondary prevention strategies following these events until this emerging clinical entity is better understood. Future studies should further assess the clinical outcomes of these two entities and their effect on future management. Keywords Troponin * Acute coronary syndrome * Risk factors * Microsize MI * Mortality