Type 2 MI and Myocardial Injury in the Era of High-sensitivity Troponin

IF 3.2 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS European Cardiology Review Pub Date : 2022-02-01 DOI:10.15420/ecr.2021.42
R. Rafiudeen, P. Barlis, H. White, W. van Gaal
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引用次数: 5

Abstract

Troponin has been the cornerstone of the definition of MI since its introduction to clinical practice. High-sensitivity troponin has allowed clinicians to detect degrees of myocardial damage at orders of magnitude smaller than previously and is challenging the definitions of MI, with implications for patient management and prognosis. Detection and diagnosis are no doubt enhanced by the greater sensitivity afforded by these markers, but perhaps at the expense of specificity and clarity. This review focuses on the definitions, pathophysiology, prognosis, prevention and management of type 2 MI and myocardial injury. The five types of MI were first defined in 2007 and were recently updated in 2018 in the fourth universal definition of MI. The authors explore how this pathophysiological classification is used in clinical practice, and discuss some of the unanswered questions in this era of availability of high-sensitivity troponin.
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高敏感性肌钙蛋白时代的2型心肌梗死与心肌损伤
肌钙蛋白自引入临床实践以来一直是心肌梗死定义的基石。高灵敏度肌钙蛋白使临床医生能够检测到比以前更小数量级的心肌损伤程度,并对心肌梗死的定义提出了挑战,对患者管理和预后具有重要意义。这些标记物所提供的更高的灵敏度无疑提高了检测和诊断,但也许是以牺牲特异性和清晰度为代价的。本文就2型心肌梗死和心肌损伤的定义、病理生理、预后、预防和治疗作一综述。这五种类型的心肌梗死于2007年首次定义,最近在2018年更新了心肌梗死的第四种通用定义。作者探讨了这种病理生理分类如何在临床实践中使用,并讨论了在这个高敏感性肌钙蛋白可用的时代一些未解决的问题。
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来源期刊
European Cardiology Review
European Cardiology Review CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
5.40
自引率
0.00%
发文量
23
审稿时长
12 weeks
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