Department of Cardiology, Odense University Hospital (OUH), Odense, Denmark.
Department of Nuclear Medicine, OUH, Centre of Health Economics Research, University of Southern Denmark, Odense, Denmark.
Am J Med. 2018 May;131(5):548-554. doi: 10.1016/j.amjmed.2017.11.043. Epub 2017 Dec 21.
Data outlining the mortality and the causes of death in patients with type 1 myocardial infarction, type 2 myocardial infarction, and those with myocardial injury are limited.
During a 1-year period from January 2010 to January 2011, all hospitalized patients who had cardiac troponin I measured on clinical indication were prospectively studied. Patients with at least one cardiac troponin I value >30 ng/L underwent case ascertainment and individual evaluation by an experienced adjudication committee. Patients were classified as having type 1 myocardial infarction, type 2 myocardial infarction, or myocardial injury according to the criteria of the universal definition of myocardial infarction. Follow-up was ensured until December 31, 2014. Data on mortality and causes of death were obtained from the Danish Civil Registration System and the Danish Register of Causes of Death.
Overall, 3762 consecutive patients were followed for a mean of 3.2 years (interquartile range 1.3-3.6 years). All-cause mortality differed significantly among categories: Type 1 myocardial infarction 31.7%, type 2 myocardial infarction 62.2%, myocardial injury 58.7%, and 22.2% in patients with nonelevated troponin values (log-rank test; P < .0001). In patients with type 1 myocardial infarction, 61.3% died from cardiovascular causes, vs 42.6% in patients with type 2 myocardial infarction (P = .015) and 41.2% in those with myocardial injury (P < .0001). The overall mortality and the causes of death did not differ substantially between patients with type 2 myocardial infarction and those with myocardial injury.
Patients with type 2 myocardial infarction and myocardial injury exhibit a significantly higher long-term mortality compared with patients with type 1 myocardial infarction . However, most patients with type 1 myocardial infarction die from cardiovascular causes in contrast to patients with type 2 myocardial infarction and myocardial injury, in whom noncardiovascular causes of death predominate.
关于 1 型心肌梗死、2 型心肌梗死和心肌损伤患者的死亡率和死因的数据有限。
在 2010 年 1 月至 2011 年 1 月的 1 年期间，对所有因临床指征检测心肌肌钙蛋白 I 的住院患者进行了前瞻性研究。至少有 1 次心肌肌钙蛋白 I 值>30ng/L 的患者进行病例确定，并由经验丰富的裁决委员会进行个体评估。根据心肌梗死的通用定义标准，将患者分为 1 型心肌梗死、2 型心肌梗死或心肌损伤。随访至 2014 年 12 月 31 日。死亡率和死因数据来自丹麦民事登记系统和丹麦死因登记处。
共有 3762 例连续患者接受了平均 3.2 年（四分位距 1.3-3.6 年）的随访。全因死亡率在不同类别之间差异显著：1 型心肌梗死 31.7%，2 型心肌梗死 62.2%，心肌损伤 58.7%，无升高肌钙蛋白值的患者为 22.2%（对数秩检验；P<0.0001）。在 1 型心肌梗死患者中，61.3%死于心血管原因，而 2 型心肌梗死患者为 42.6%（P=0.015），心肌损伤患者为 41.2%（P<0.0001）。2 型心肌梗死和心肌损伤患者的总体死亡率和死因无显著差异。
与 1 型心肌梗死患者相比，2 型心肌梗死和心肌损伤患者的长期死亡率显著升高。然而，与 2 型心肌梗死和心肌损伤患者相比，大多数 1 型心肌梗死患者死于心血管原因，而非心血管原因是这些患者死亡的主要原因。
