Table 2.
Management and Outcomes of Patients with Type 1 Myocardial Infarction, Type 2 Myocardial Infarction, and Myocardial Injury
| Type 1 MI (n = 1171) | Type 2 MI (n = 429) | Myocardial Injury (n = 522) | P Value/RR Type 1 Versus Type 2‖ | P Value/RR Type 2 Versus Myocardial Injury¶ | |
|---|---|---|---|---|---|
| Management, n (%), median (IQR) | |||||
| Cardiology referral | 1004 (87%) | 181 (43%) | 146 (29%) | <.001 | <.001 |
| Length of stay, median days (IQR) | 4 (2-7) | 7 (2-17) | 10 (4-23) | <.001 | <.001 |
| Investigations, n (%) | |||||
| Echocardiography | 340 (30%) | 122 (29%) | 117 (23%) | .535 | .042 |
| Exercise tolerance test | 29 (3%) | 1 (0%) | 0 (0%) | .003 | .451 |
| Angiography | 744 (65%) | 31 (7%) | 19 (4%) | <.001 | .012 |
| Coronary revascularization, n (%) | |||||
| PCI | 564 (49%) | 1 (0%) | 3 (1%) | <.001 | .632 |
| CABG | 56 (5%) | 3 (1%) | 3 (1%) | <.001 | .999 |
| Medications on discharge, n (%) | |||||
| Aspirin | 910 (90%) | 166 (49%) | 192 (49%) | <.001 | .835 |
| Clopidogrel | 831 (80%) | 48 (14%) | 38 (9%) | <.001 | .052 |
| Dual antiplatelet therapy | 789 (76%) | 26 (7%) | 26 (6%) | <.001 | .547 |
| ß-blockers | 660 (63%) | 124 (36%) | 114 (28%) | <.001 | .02 |
| ACE inhibitors | 735 (71%) | 135 (39%) | 159 (39%) | <.001 | .999 |
| Statins | 884 (85%) | 152 (44%) | 190 (46%) | <.001 | .442 |
| Warfarin | 35 (3%) | 52 (15%) | 61 (15%) | <.001 | .965 |
| Proton pump inhibitors | 304 (29%) | 135 (39%) | 150 (37%) | .001 | .508 |
| Outcomes, n (%) | |||||
| Recurrent MI∗ | 141 (12%) | 24 (6%) | 18 (3%) | .46 (0.31-0.71) | .62 (0.34-1.12) |
| Death | 187 (16%) | 134 (31%) | 193 (37%) | 1.95 (1.61-2.37) | 1.19 (0.99-1.42) |
| Recurrent MI/death | 280 (24%) | 144 (34%) | 203 (39%) | 1.40 (1.19-1.66) | 1.16 (0.98-1.38) |
| Gastrointestinal bleeding† | 20 (2%) | 11 (3%) | 7 (1%) | 1.50 (0.73-3.11) | .52 (0.21-1.34) |
| Stroke‡ | 24 (2%) | 11 (3%) | 22 (4%) | 1.25 (0.61-2.53) | 1.64 (0.81-3.35) |
| Coronary revascularization§ | 95 (8%) | 5 (1%) | 5 (1%) | .14 (0.06-0.35) | .82 (0.24-2.82) |
ACE = angiotensin-converting enzyme; CABG = coronary artery bypass grafting; IQR = interquartile range; MI = myocardial infarction; PCI = percutaneous coronary intervention; RR = relative risk.
∗
Recurrent type 1 myocardial infarction.
†
Includes type II–V bleeding as defined in the recent consensus statement.11
‡
Defined as stroke by the attending physician.
§
Coronary revascularization includes both percutaneous coronary intervention and coronary artery bypass grafting.
‖
Type 1 myocardial infarction as referent.
¶
Type 2 myocardial infarction as referent.