Gupta Sonu, Vaidya Satyanarayana R, Arora Sameer, Bahekar Amol, Devarapally Santhosh R
Department of Internal Medicine, Cape Fear Valley Medical Center, Fayetteville, NC, USA.
Division of Cardiology, University of North Carolina, Chapel Hill, NC, USA.
Cardiovasc Diagn Ther. 2017 Aug;7(4):348-358. doi: 10.21037/cdt.2017.03.21.
Type 2 myocardial infarction (MI) is an imbalance between myocardial oxygen demand and supply, leading to myocardial ischemia. It is not due to plaque rupture, and is usually caused by a condition other than coronary artery disease (CAD). However, limited data are available comparing the prevalence of traditional coronary risk factors and mortality between type 1 and type 2 MI. We hypothesize that type 2 MI carries a higher mortality than type 1.
We searched the databases of PubMed, EMBASE, CENTRAL, and MEDLINE for studies comparing type 1 MI with type 2 MI. The baseline variables were compared in each cohort. Summary risk ratios and 95% confidence intervals were calculated using the random effects model to compare mortality between the two groups.
The included studies yielded 25,872 patients of whom 2,683 (10%) had type 2 MI. Compared to the type 1 cohort, the type 2 cohort had significantly higher inpatient (15% 4.7%, P<0.00001), 30-day (17.6% 5.3%, P<0.00001) and 1-yr mortality (27% 13%, P<0.00001), as well as higher 30-day major adverse cardiovascular events (20% 9%, P<0.0001). Operative stress (20%) was the most common trigger of type 2 MI, followed by sepsis (19%), arrhythmia (18.63%), heart failure (15%), and anemia (12%).
Type 2 MI is a common entity and is more common in females, older age groups, and in patients with multiple comorbidities: it also tends to result in higher mortality.
2型心肌梗死（MI）是心肌氧需求与供应之间的失衡，导致心肌缺血。它并非由斑块破裂引起，通常由冠状动脉疾病（CAD）以外的疾病导致。然而，关于1型和2型MI之间传统冠状动脉危险因素的患病率及死亡率比较的数据有限。我们假设2型MI的死亡率高于1型。
我们检索了PubMed、EMBASE、CENTRAL和MEDLINE数据库，以查找比较1型MI和2型MI的研究。对每个队列的基线变量进行比较。使用随机效应模型计算汇总风险比和95%置信区间，以比较两组之间的死亡率。
纳入的研究共涉及25872例患者，其中2683例（10%）为2型MI。与1型队列相比，2型队列的住院死亡率（15%对4.7%，P<0.00001）、30天死亡率（17.6%对5.3%，P<0.00001）和1年死亡率（27%对13%，P<0.00001）均显著更高，30天主要不良心血管事件发生率也更高（20%对9%，P<0.0001）。手术应激（20%）是2型MI最常见的诱因，其次是脓毒症（19%）、心律失常（18.63%）、心力衰竭（15%）和贫血（12%）。
2型MI是一种常见病症，在女性、老年人群以及患有多种合并症的患者中更为常见，其死亡率也往往更高。
