Sato Ryota, Sakamoto Kenji, Kaikita Koichi, Tsujita Kenichi, Nakao Koichi, Ozaki Yukio, Kimura Kazuo, Ako Junya, Noguchi Teruo, Yasuda Satoshi, Suwa Satoru, Fujimoto Kazuteru, Nakama Yasuharu, Morita Takashi, Shimizu Wataru, Saito Yoshihiko, Hirohata Atsushi, Morita Yasuhiro, Inoue Teruo, Okamura Atsunori, Mano Toshiaki, Hirata Kazuhito, Tanabe Kengo, Shibata Yoshisato, Owa Mafumi, Funayama Hiroshi, Kokubu Nobuaki, Kozuma Ken, Uemura Shirou, Toubaru Tetsuya, Saku Keijirou, Ohshima Shigeru, Nishimura Kunihiro, Miyamoto Yoshihiro, Ogawa Hisao, Ishihara Masaharu
Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto 860-8556, Japan.
Division of Cardiology, Saiseikai Kumamoto Hospital Cardiovascular Center, Kumamoto 861-4193, Japan.
J Clin Med. 2020 Jun 2;9(6):1686. doi: 10.3390/jcm9061686.
While prognoses in relation to myocardial infarction (MI) type have been elucidated in past reports, the results were not consistent, perhaps due to occurrence of Type 2 MI with CVS and its mortality. The Japanese registry of acute Myocardial Infarction diagnosed by Universal Definition (J-MINUET) is a prospective multicenter registry in Japan. In contrast to thromboembolic event-related Type 1 myocardial infarction (MI), clinical features of Type 2 MI, including coronary vasospasm (CVS), are varied due to the heterogeneous nature of its development. To elucidate the MI type-related all-cause mortality, 2989 consecutive patients with AMI were stratified as Type 1 MI, Type 2 MI with CVS, and Type 2 MI with non-CVS. Most patients ( = 2834; 94.8%) were classified as Type 1 MI and 155 patients (5.2%) were classified as Type 2 MI. Of the Type 2 MI patients, 87 (56% of Type 2 MI) were diagnosed as MI with CVS. Although the 3-year mortality was comparable between Type 1 and Type 2 MI patients, significant differences were observed between Type 2 MI with CVS and with non-CVS (3.4% and 22.1%, < 0.001). Among Japanese patients with AMI, mortality rates between Type 1 MI and Type 2 MI are comparable, but further stratification of Type 2 MI (with or without CVS) may be useful in predicting the prognosis of patients with Type 2 MI.
虽然过去的报告已经阐明了与心肌梗死（MI）类型相关的预后情况，但结果并不一致，这可能是由于2型MI合并冠状动脉痉挛（CVS）的发生及其死亡率所致。日本通用定义诊断的急性心肌梗死登记系统（J-MINUET）是日本的一项前瞻性多中心登记系统。与血栓栓塞事件相关的1型心肌梗死（MI）不同，2型MI的临床特征，包括冠状动脉痉挛（CVS），因其发展的异质性而各不相同。为了阐明MI类型相关的全因死亡率，将2989例连续的急性心肌梗死患者分为1型MI、合并CVS的2型MI和不合并CVS的2型MI。大多数患者（n = 2834；94.8%）被归类为1型MI，155例患者（5.2%）被归类为2型MI。在2型MI患者中，87例（占2型MI的56%）被诊断为合并CVS的MI。虽然1型和2型MI患者的3年死亡率相当，但合并CVS和不合并CVS的2型MI之间存在显著差异（3.4%和22.1%，P < 0.001）。在日本急性心肌梗死患者中，1型MI和2型MI的死亡率相当，但对2型MI（有无CVS）进行进一步分层可能有助于预测2型MI患者的预后。
