Putot Alain, Monin Antoine, Belkouche Alban, Chagué Frédéric, Zeller Marianne, Cottin Yves
Equipe PEC2 (Physiopathologie et Epidémiologie Cérébro-Cardiovasculaires), EA 7460, University of Burgundy.
Department of Geriatrics.
Cardiovasc Endocrinol Metab. 2022 Jun 28;11(3):e0267. doi: 10.1097/XCE.0000000000000267. eCollection 2022 Sep.
The aim of the study was to evaluate the incidence and prognosis of type 1 myocardial infarction (T1MI) and type 2 MI (T2MI) in patients with acute MI and known atrial fibrillation (AF) to identify MI directly linked to AF. Among the 669 patients, four patients with hyperthyroidism were excluded, and among the remaining 665 patients, about two-thirds were diagnosed with T1MI, and the remaining third were diagnosed with T2MI. AF was the direct cause of MI in 9.8% of our overall population [1.8% of T1MI type C (coronary embolism), 4.9% of T2MI type A and 3.1% of T2MI type B]. Among patients with T2MI, 30-day mortality was lower when the trigger was AF than for the other triggers, for both type 2A (6% vs. 11%) and type 2B (0% vs. 13%). Most cases of AF-related MI are, thus, T2MI, for which therapeutic guidelines are lacking. Given the diverse triggers in T2MI, a specific approach using etiological patterns is needed to properly determine the optimal therapeutic.
本研究的目的是评估急性心肌梗死（MI）且已知患有心房颤动（AF）的患者中1型心肌梗死（T1MI）和2型MI（T2MI）的发生率及预后，以确定与AF直接相关的MI。在669例患者中，排除了4例甲状腺功能亢进患者，在其余665例患者中，约三分之二被诊断为T1MI，其余三分之一被诊断为T2MI。AF是我们总体人群中9.8%的MI的直接病因[C型T1MI（冠状动脉栓塞）的1.8%、2A型T2MI的4.9%和2B型T2MI的3.1%]。在T2MI患者中，当触发因素为AF时，2A 型（6%对11%）和2B型（0%对13%）的30天死亡率均低于其他触发因素。因此，大多数AF相关的MI病例为T2MI，目前缺乏针对T2MI的治疗指南。鉴于T2MI存在多种触发因素，需要采用基于病因模式的特定方法来正确确定最佳治疗方案。
