title: Type 2 myocardial infarction in clinical practice.
abstract: OBJECTIVE
  We aimed to assess differences in incidence, clinical features, current treatment strategies and outcome in patients with type 2 vs. type 1 acute myocardial infarction (AMI).
  
  
  RESULTS
  All 20 138 hospitalisations in Sweden with a diagnosis of AMI registered during 2011 in the Swedish Web-system for Enhancement and Development of Evidence-based care in Heart disease Evaluated According to Recommended Therapies were classified into types 1-5 in accordance with the universal definition of myocardial infarction (MI) from 2007. Type 1 AMI was present in 88.5% of the cases while 7.1% were classified as type 2 AMI. Higher age, female sex, comorbidities, impaired renal function, anaemia and smaller extent of myocardial necrosis characterised patients with type 2 AMI. While normal coronary arteries were more frequently seen (42.4% vs. 7.4%), an invasive treatment was less common, and antiplatelet medications were less prescribed in patients with type 2 AMI compared with type 1 AMI. The group with type 2 AMI had significantly higher crude 1-year mortality compared with the group with type 1 AMI (24.7% vs. 13.5%, p<0.001). However, after adjustment, the HR for 1-year mortality in patients with type 2 AMI was 1.03 (95% CI 0.86 to 1.23).
  
  
  CONCLUSIONS
  In this real-life study, 7.1% of myocardial infarctions were classified as type 2 AMI. These patients were older, predominantly women and had more comorbidities. Invasive treatment strategies and cardioprotective medications were less used. Patients with type 2 AMI had higher crude mortality compared with type 1 patients with MI. However, after adjustment, the 1-year mortality was similar.
authors.affiliation: Department of Medical Sciences, Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Baron
authors.affiliation: Department of Cardiology, Falun Hospital, Falun, Sweden.
authors.forename: Kristina
authors.initials: K
authors.lastname: Hambraeus
authors.affiliation: Department of Medical Sciences, Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden.
authors.forename: Johan
authors.initials: J
authors.lastname: Sundström
authors.affiliation: Department of Cardiology, Lund University, Skane University Hospital, Lund, Sweden.
authors.forename: David
authors.initials: D
authors.lastname: Erlinge
authors.affiliation: Department of Cardiology, Karolinska Institute, Karolinska University Hospital, Huddinge, Stockholm, Sweden.
authors.forename: Tomas
authors.initials: T
authors.lastname: Jernberg
authors.affiliation: Department of Medical Sciences, Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden.
authors.forename: Bertil
authors.initials: B
authors.lastname: Lindahl
mesh_terms: D000367:Age Factors; D000368:Aged; D000740:Anemia / Q000453:epidemiology*; D015897:Comorbidity; D003331:Coronary Vessels / Q000473:pathology; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008297:Male; D009026:Mortality; D009203:Myocardial Infarction / Q000145:classification / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D009204:Myocardial Revascularization / Q000379:methods / Q000706:statistics & numerical data; D017063:Outcome Assessment, Health Care; D062072:Patient Acuity; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D012042:Registries; D051437:Renal Insufficiency / Q000453:epidemiology*; D012307:Risk Factors; D012737:Sex Factors; D013548:Sweden / Q000453:epidemiology
chemical_list: D010975:Platelet Aggregation Inhibitors
keywords: MYOCARDIAL ISCHAEMIA AND INFARCTION (IHD)