Impact of changing definitions for myocardial infarction : a report from the AMIS registry

Urban, P. and Radovanovic, D. and Erne, P. and Stauffer, J. C. and Pedrazzini, G. and Windecker, S. and Bertel, O. and Amis, Plus Investigators. (2008) Impact of changing definitions for myocardial infarction : a report from the AMIS registry. The American journal of medicine, Vol. 121, H. 12. pp. 1065-1071.

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Official URL: http://edoc.unibas.ch/dok/A6005627

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BACKGROUND: To assess the impact of the new definitions of myocardial infarction, we retrospectively analyzed 9190 patients from 63 hospitals with reported peak troponin values included between 2001 and 2007 in the Swiss AMIS (Acute Myocardial Infarction in Switzerland) Plus registry. METHODS: Patients were classified as belonging to the "classic" myocardial infarction group (peak total CK or CK-MB above the upper limit of normal, or troponin T [TnT] <0.1 microg/L or troponin I [TnI] <0.1-0.8 microg/L [depending on the assay]) or "new" myocardial infarction group (TnT <0.01 microg/L or TnI <0.01-0.07 microg/L). RESULTS: There were 489 patients in the "new" group who were similar to the 8701 "classic" patients in terms of age, sex, and prevalence of both diabetes and renal failure, but more frequently had a history of prior coronary artery disease, hypertension, and hyperlipidemia. At admission, they less frequently had ST elevation on their electrocardiogram, were more frequently in Killip class I, and received less primary percutaneous coronary intervention. Hospital mortality was 3.5% in the "new" and 6.7% in the "classic" myocardial infarction group (P=.004). In a subset of patients with a longer follow-up, mortality at 3 and 12 months was 1% and 5.6%, respectively, for "new" and 1.6% and 4%, respectively, for "classic" myocardial infarction (NS). CONCLUSIONS: Patients with minimal elevation of serum troponin have smaller infarctions, less aggressive treatment, fewer early complications, and a better early prognosis than patients with higher serum biomarker levels. After discharge, however, their prognosis currently appears no different from that of patients with a "classic" myocardial infarction event.
Faculties and Departments:03 Faculty of Medicine > Departement Biomedizin > Further Research Groups at DBM > Signal Transduction (Resink/Erne)
UniBasel Contributors:Erne, Paul
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:Excerpta Medica
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:25 Apr 2014 08:00
Deposited On:25 Apr 2014 08:00

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