Will the universal definition of myocardial infarction criteria result in an overdiagnosis of myocardial infarction?
The Universal Definition of Myocardial Infarction (acute myocardial infarction [AMI]) requires detection of increasing or decreasing cardiac biomarkers (preferably cardiac troponin) with >or=1 value >99(th) percentile, together with either clinical symptoms, new ischemic electrocardiographic changes, or typical imaging findings indicative of myocardial necrosis as diagnostic criteria for AMI. However, a small cardiac troponin elevation together with ST-T segment abnormalities may also occur in clinically stable populations. Accordingly, 0.6% of elderly subjects from a community sample (PIVUS Study) and 6.7% of patients stabilized after an acute coronary syndrome (FRISC II Study) would have been labeled AMI following the Universal Definition of AMI when diagnostic classification had been based on a single cardiac troponin I result. In conclusion, our results emphasized the importance of a significant change in cardiac troponin to avoid misdiagnosis of AMI.
Eggers
Kai M
KM
Department of Medical Sciences, Uppsala University Hospital, Sweden. kai.eggers@ucr.uu.se
Lind
Lars
L
Venge
Per
P
Lindahl
Bertil
B
D000368:Aged; D015415:Biomarkers / Q000097:blood; D003951:Diagnostic Errors; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000145:classification / Q000175:diagnosis*; D019210:Troponin I / Q000097:blood*
D015415:Biomarkers; D019210:Troponin I