Outcomes following acute myocardial injury and type 2 myocardial infarction in patients with and without coronary artery disease

Abstract Background Acute myocardial injury and type 2 infarction typically occur in the setting of a concurrent illness. Differentiating acute from is challenging as it relies on assessment ischaemia. Indeed, some have questioned whether this distinction important, patients with both conditions are at increased risk future cardiovascular events. Whether similar role identifying those coronary artery disease uncertain. Purpose To determine events death differs according to presence or absence prior disease. Methods We conducted secondary analysis multi-centre randomised controlled trial 48,282 consecutive suspected syndrome. Patients an adjudicated index diagnosis were stratified they known previously defined revascularisation, infarction, angina. Cardiovascular adjusted for competing non-cardiovascular all-cause one year was compared. Results In 9,115 elevated cardiac troponin concentrations, 1,676 (18%) 1,121 (12%) had respectively. either condition older (mean [standard deviation] age 78 [11] versus 73 [16] years) more likely be female (55% 45%) than no history. Coronary identified 40% (454/1,121) 30% (509/1,167) injury, common without (23% [115/509]) 14% [158/1,167]; P<0.001) (20% [91/454] 10% [69/667]; log-rank (Figure 1). Similarly higher (31% [357/1,167] 18% [123/667]; (40% [115/509] [135/454]; 2). Conclusion recognised around third associated rates death. Risk doubled suggesting that investigation prevention may conditions. Funding Acknowledgement Type funding sources: Foundation. Main source(s): The University Edinburgh British Heart Foundation