The Variation in Recovery: Role of Gender on Outcomes of Young AMI Patients (VIRGO) Classification System: A Taxonomy for Young Women With Acute Myocardial Infarction.
BACKGROUND
Current classification schemes for acute myocardial infarction (AMI) may not accommodate the breadth of clinical phenotypes in young women.


RESULTS
We developed a novel taxonomy among young adults (≤55 years) with AMI enrolled in the Variation in Recovery: Role of Gender on Outcomes of Young AMI Patients (VIRGO) study. We first classified a subset of patients (n=600) according to the Third Universal Definition of MI using a structured abstraction tool. There was heterogeneity within type 2 AMI, and 54 patients (9%; including 51 of 412 women) were unclassified. Using an inductive approach, we iteratively grouped patients with shared clinical characteristics, with the aims of developing a more inclusive taxonomy that could distinguish unique clinical phenotypes. The final VIRGO taxonomy classified 2802 study participants as follows: class 1, plaque-mediated culprit lesion (82.5% of women; 94.9% of men); class 2, obstructive coronary artery disease with supply-demand mismatch (2a: 1.4% women; 0.9% men) and without supply-demand mismatch (2b: 2.4% women; 1.1% men); class 3, nonobstructive coronary artery disease with supply-demand mismatch (3a: 4.3% women; 0.8% men) and without supply-demand mismatch (3b: 7.0% women; 1.9% men); class 4, other identifiable mechanism (spontaneous dissection, vasospasm, embolism; 1.5% women, 0.2% men); and class 5, undetermined classification (0.8% women, 0.2% men).


CONCLUSIONS
Approximately 1 in 8 young women with AMI is unclassified by the Universal Definition of MI. We propose a more inclusive taxonomy that could serve as a framework for understanding biological disease mechanisms, therapeutic efficacy, and prognosis in this population.
From Section of Cardiovascular Medicine, Department of Internal Medicine (E.S.S., J.P.C., A.J.L., J.F.L., R.P.D., K.M., H.M.K.), Section of General Internal Medicine, Department of Internal Medicine (C.P.G., S.I.C.), Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine (L.A.C., C.P.G., H.M.K.), Yale Cardiovascular Research Group, Department of Internal Medicine (A.J.L.), and Department of Emergency Medicine (G.D., B.S.), Yale School of Medicine, New Haven, CT; Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, CT (E.S.S., S.Z., K.M.S., J.P.C., J.A.S.B.-F., J.F.L., H.B., R.P.D., K.M., H.M.K.); Department of Health Policy and Management, Yale School of Public Health, New Haven, CT (L.A.C., H.M.K.); Division of Cardiology, University of Colorado Anschutz Medical Campus, Aurora (F.A.M.); Division of Cardiology, Federal University of Sergipe, and the Clínica e Hospital São Lucas, Aracaju, Brazil (J.A.S.B.-F.); Department of Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain (H.B.); and University of Kansas City-Missouri and Saint Luke's Mid America Heart Institute, Kansas City (J.A.S.).
Erica S
ES
Spatz
From Section of Cardiovascular Medicine, Department of Internal Medicine (E.S.S., J.P.C., A.J.L., J.F.L., R.P.D., K.M., H.M.K.), Section of General Internal Medicine, Department of Internal Medicine (C.P.G., S.I.C.), Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine (L.A.C., C.P.G., H.M.K.), Yale Cardiovascular Research Group, Department of Internal Medicine (A.J.L.), and Department of Emergency Medicine (G.D., B.S.), Yale School of Medicine, New Haven, CT; Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, CT (E.S.S., S.Z., K.M.S., J.P.C., J.A.S.B.-F., J.F.L., H.B., R.P.D., K.M., H.M.K.); Department of Health Policy and Management, Yale School of Public Health, New Haven, CT (L.A.C., H.M.K.); Division of Cardiology, University of Colorado Anschutz Medical Campus, Aurora (F.A.M.); Division of Cardiology, Federal University of Sergipe, and the Clínica e Hospital São Lucas, Aracaju, Brazil (J.A.S.B.-F.); Department of Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain (H.B.); and University of Kansas City-Missouri and Saint Luke's Mid America Heart Institute, Kansas City (J.A.S.).
Leslie A
LA
Curry
From Section of Cardiovascular Medicine, Department of Internal Medicine (E.S.S., J.P.C., A.J.L., J.F.L., R.P.D., K.M., H.M.K.), Section of General Internal Medicine, Department of Internal Medicine (C.P.G., S.I.C.), Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine (L.A.C., C.P.G., H.M.K.), Yale Cardiovascular Research Group, Department of Internal Medicine (A.J.L.), and Department of Emergency Medicine (G.D., B.S.), Yale School of Medicine, New Haven, CT; Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, CT (E.S.S., S.Z., K.M.S., J.P.C., J.A.S.B.-F., J.F.L., H.B., R.P.D., K.M., H.M.K.); Department of Health Policy and Management, Yale School of Public Health, New Haven, CT (L.A.C., H.M.K.); Division of Cardiology, University of Colorado Anschutz Medical Campus, Aurora (F.A.M.); Division of Cardiology, Federal University of Sergipe, and the Clínica e Hospital São Lucas, Aracaju, Brazil (J.A.S.B.-F.); Department of Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain (H.B.); and University of Kansas City-Missouri and Saint Luke's Mid America Heart Institute, Kansas City (J.A.S.).
Frederick A
FA
Masoudi
From Section of Cardiovascular Medicine, Department of Internal Medicine (E.S.S., J.P.C., A.J.L., J.F.L., R.P.D., K.M., H.M.K.), Section of General Internal Medicine, Department of Internal Medicine (C.P.G., S.I.C.), Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine (L.A.C., C.P.G., H.M.K.), Yale Cardiovascular Research Group, Department of Internal Medicine (A.J.L.), and Department of Emergency Medicine (G.D., B.S.), Yale School of Medicine, New Haven, CT; Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, CT (E.S.S., S.Z., K.M.S., J.P.C., J.A.S.B.-F., J.F.L., H.B., R.P.D., K.M., H.M.K.); Department of Health Policy and Management, Yale School of Public Health, New Haven, CT (L.A.C., H.M.K.); Division of Cardiology, University of Colorado Anschutz Medical Campus, Aurora (F.A.M.); Division of Cardiology, Federal University of Sergipe, and the Clínica e Hospital São Lucas, Aracaju, Brazil (J.A.S.B.-F.); Department of Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain (H.B.); and University of Kansas City-Missouri and Saint Luke's Mid America Heart Institute, Kansas City (J.A.S.).
Shengfan
S
Zhou
From Section of Cardiovascular Medicine, Department of Internal Medicine (E.S.S., J.P.C., A.J.L., J.F.L., R.P.D., K.M., H.M.K.), Section of General Internal Medicine, Department of Internal Medicine (C.P.G., S.I.C.), Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine (L.A.C., C.P.G., H.M.K.), Yale Cardiovascular Research Group, Department of Internal Medicine (A.J.L.), and Department of Emergency Medicine (G.D., B.S.), Yale School of Medicine, New Haven, CT; Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, CT (E.S.S., S.Z., K.M.S., J.P.C., J.A.S.B.-F., J.F.L., H.B., R.P.D., K.M., H.M.K.); Department of Health Policy and Management, Yale School of Public Health, New Haven, CT (L.A.C., H.M.K.); Division of Cardiology, University of Colorado Anschutz Medical Campus, Aurora (F.A.M.); Division of Cardiology, Federal University of Sergipe, and the Clínica e Hospital São Lucas, Aracaju, Brazil (J.A.S.B.-F.); Department of Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain (H.B.); and University of Kansas City-Missouri and Saint Luke's Mid America Heart Institute, Kansas City (J.A.S.).
Kelly M
KM
Strait
From Section of Cardiovascular Medicine, Department of Internal Medicine (E.S.S., J.P.C., A.J.L., J.F.L., R.P.D., K.M., H.M.K.), Section of General Internal Medicine, Department of Internal Medicine (C.P.G., S.I.C.), Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine (L.A.C., C.P.G., H.M.K.), Yale Cardiovascular Research Group, Department of Internal Medicine (A.J.L.), and Department of Emergency Medicine (G.D., B.S.), Yale School of Medicine, New Haven, CT; Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, CT (E.S.S., S.Z., K.M.S., J.P.C., J.A.S.B.-F., J.F.L., H.B., R.P.D., K.M., H.M.K.); Department of Health Policy and Management, Yale School of Public Health, New Haven, CT (L.A.C., H.M.K.); Division of Cardiology, University of Colorado Anschutz Medical Campus, Aurora (F.A.M.); Division of Cardiology, Federal University of Sergipe, and the Clínica e Hospital São Lucas, Aracaju, Brazil (J.A.S.B.-F.); Department of Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain (H.B.); and University of Kansas City-Missouri and Saint Luke's Mid America Heart Institute, Kansas City (J.A.S.).
Cary P
CP
Gross
From Section of Cardiovascular Medicine, Department of Internal Medicine (E.S.S., J.P.C., A.J.L., J.F.L., R.P.D., K.M., H.M.K.), Section of General Internal Medicine, Department of Internal Medicine (C.P.G., S.I.C.), Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine (L.A.C., C.P.G., H.M.K.), Yale Cardiovascular Research Group, Department of Internal Medicine (A.J.L.), and Department of Emergency Medicine (G.D., B.S.), Yale School of Medicine, New Haven, CT; Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, CT (E.S.S., S.Z., K.M.S., J.P.C., J.A.S.B.-F., J.F.L., H.B., R.P.D., K.M., H.M.K.); Department of Health Policy and Management, Yale School of Public Health, New Haven, CT (L.A.C., H.M.K.); Division of Cardiology, University of Colorado Anschutz Medical Campus, Aurora (F.A.M.); Division of Cardiology, Federal University of Sergipe, and the Clínica e Hospital São Lucas, Aracaju, Brazil (J.A.S.B.-F.); Department of Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain (H.B.); and University of Kansas City-Missouri and Saint Luke's Mid America Heart Institute, Kansas City (J.A.S.).
Jeptha P
JP
Curtis
From Section of Cardiovascular Medicine, Department of Internal Medicine (E.S.S., J.P.C., A.J.L., J.F.L., R.P.D., K.M., H.M.K.), Section of General Internal Medicine, Department of Internal Medicine (C.P.G., S.I.C.), Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine (L.A.C., C.P.G., H.M.K.), Yale Cardiovascular Research Group, Department of Internal Medicine (A.J.L.), and Department of Emergency Medicine (G.D., B.S.), Yale School of Medicine, New Haven, CT; Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, CT (E.S.S., S.Z., K.M.S., J.P.C., J.A.S.B.-F., J.F.L., H.B., R.P.D., K.M., H.M.K.); Department of Health Policy and Management, Yale School of Public Health, New Haven, CT (L.A.C., H.M.K.); Division of Cardiology, University of Colorado Anschutz Medical Campus, Aurora (F.A.M.); Division of Cardiology, Federal University of Sergipe, and the Clínica e Hospital São Lucas, Aracaju, Brazil (J.A.S.B.-F.); Department of Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain (H.B.); and University of Kansas City-Missouri and Saint Luke's Mid America Heart Institute, Kansas City (J.A.S.).
Alexandra J
AJ
Lansky
From Section of Cardiovascular Medicine, Department of Internal Medicine (E.S.S., J.P.C., A.J.L., J.F.L., R.P.D., K.M., H.M.K.), Section of General Internal Medicine, Department of Internal Medicine (C.P.G., S.I.C.), Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine (L.A.C., C.P.G., H.M.K.), Yale Cardiovascular Research Group, Department of Internal Medicine (A.J.L.), and Department of Emergency Medicine (G.D., B.S.), Yale School of Medicine, New Haven, CT; Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, CT (E.S.S., S.Z., K.M.S., J.P.C., J.A.S.B.-F., J.F.L., H.B., R.P.D., K.M., H.M.K.); Department of Health Policy and Management, Yale School of Public Health, New Haven, CT (L.A.C., H.M.K.); Division of Cardiology, University of Colorado Anschutz Medical Campus, Aurora (F.A.M.); Division of Cardiology, Federal University of Sergipe, and the Clínica e Hospital São Lucas, Aracaju, Brazil (J.A.S.B.-F.); Department of Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain (H.B.); and University of Kansas City-Missouri and Saint Luke's Mid America Heart Institute, Kansas City (J.A.S.).
Jose Augusto
JA
Soares Barreto-Filho
From Section of Cardiovascular Medicine, Department of Internal Medicine (E.S.S., J.P.C., A.J.L., J.F.L., R.P.D., K.M., H.M.K.), Section of General Internal Medicine, Department of Internal Medicine (C.P.G., S.I.C.), Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine (L.A.C., C.P.G., H.M.K.), Yale Cardiovascular Research Group, Department of Internal Medicine (A.J.L.), and Department of Emergency Medicine (G.D., B.S.), Yale School of Medicine, New Haven, CT; Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, CT (E.S.S., S.Z., K.M.S., J.P.C., J.A.S.B.-F., J.F.L., H.B., R.P.D., K.M., H.M.K.); Department of Health Policy and Management, Yale School of Public Health, New Haven, CT (L.A.C., H.M.K.); Division of Cardiology, University of Colorado Anschutz Medical Campus, Aurora (F.A.M.); Division of Cardiology, Federal University of Sergipe, and the Clínica e Hospital São Lucas, Aracaju, Brazil (J.A.S.B.-F.); Department of Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain (H.B.); and University of Kansas City-Missouri and Saint Luke's Mid America Heart Institute, Kansas City (J.A.S.).
Julianna F
JF
Lampropulos
From Section of Cardiovascular Medicine, Department of Internal Medicine (E.S.S., J.P.C., A.J.L., J.F.L., R.P.D., K.M., H.M.K.), Section of General Internal Medicine, Department of Internal Medicine (C.P.G., S.I.C.), Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine (L.A.C., C.P.G., H.M.K.), Yale Cardiovascular Research Group, Department of Internal Medicine (A.J.L.), and Department of Emergency Medicine (G.D., B.S.), Yale School of Medicine, New Haven, CT; Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, CT (E.S.S., S.Z., K.M.S., J.P.C., J.A.S.B.-F., J.F.L., H.B., R.P.D., K.M., H.M.K.); Department of Health Policy and Management, Yale School of Public Health, New Haven, CT (L.A.C., H.M.K.); Division of Cardiology, University of Colorado Anschutz Medical Campus, Aurora (F.A.M.); Division of Cardiology, Federal University of Sergipe, and the Clínica e Hospital São Lucas, Aracaju, Brazil (J.A.S.B.-F.); Department of Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain (H.B.); and University of Kansas City-Missouri and Saint Luke's Mid America Heart Institute, Kansas City (J.A.S.).
Hector
H
Bueno
From Section of Cardiovascular Medicine, Department of Internal Medicine (E.S.S., J.P.C., A.J.L., J.F.L., R.P.D., K.M., H.M.K.), Section of General Internal Medicine, Department of Internal Medicine (C.P.G., S.I.C.), Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine (L.A.C., C.P.G., H.M.K.), Yale Cardiovascular Research Group, Department of Internal Medicine (A.J.L.), and Department of Emergency Medicine (G.D., B.S.), Yale School of Medicine, New Haven, CT; Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, CT (E.S.S., S.Z., K.M.S., J.P.C., J.A.S.B.-F., J.F.L., H.B., R.P.D., K.M., H.M.K.); Department of Health Policy and Management, Yale School of Public Health, New Haven, CT (L.A.C., H.M.K.); Division of Cardiology, University of Colorado Anschutz Medical Campus, Aurora (F.A.M.); Division of Cardiology, Federal University of Sergipe, and the Clínica e Hospital São Lucas, Aracaju, Brazil (J.A.S.B.-F.); Department of Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain (H.B.); and University of Kansas City-Missouri and Saint Luke's Mid America Heart Institute, Kansas City (J.A.S.).
Sarwat I
SI
Chaudhry
From Section of Cardiovascular Medicine, Department of Internal Medicine (E.S.S., J.P.C., A.J.L., J.F.L., R.P.D., K.M., H.M.K.), Section of General Internal Medicine, Department of Internal Medicine (C.P.G., S.I.C.), Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine (L.A.C., C.P.G., H.M.K.), Yale Cardiovascular Research Group, Department of Internal Medicine (A.J.L.), and Department of Emergency Medicine (G.D., B.S.), Yale School of Medicine, New Haven, CT; Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, CT (E.S.S., S.Z., K.M.S., J.P.C., J.A.S.B.-F., J.F.L., H.B., R.P.D., K.M., H.M.K.); Department of Health Policy and Management, Yale School of Public Health, New Haven, CT (L.A.C., H.M.K.); Division of Cardiology, University of Colorado Anschutz Medical Campus, Aurora (F.A.M.); Division of Cardiology, Federal University of Sergipe, and the Clínica e Hospital São Lucas, Aracaju, Brazil (J.A.S.B.-F.); Department of Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain (H.B.); and University of Kansas City-Missouri and Saint Luke's Mid America Heart Institute, Kansas City (J.A.S.).
Gail
G
D'Onofrio
From Section of Cardiovascular Medicine, Department of Internal Medicine (E.S.S., J.P.C., A.J.L., J.F.L., R.P.D., K.M., H.M.K.), Section of General Internal Medicine, Department of Internal Medicine (C.P.G., S.I.C.), Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine (L.A.C., C.P.G., H.M.K.), Yale Cardiovascular Research Group, Department of Internal Medicine (A.J.L.), and Department of Emergency Medicine (G.D., B.S.), Yale School of Medicine, New Haven, CT; Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, CT (E.S.S., S.Z., K.M.S., J.P.C., J.A.S.B.-F., J.F.L., H.B., R.P.D., K.M., H.M.K.); Department of Health Policy and Management, Yale School of Public Health, New Haven, CT (L.A.C., H.M.K.); Division of Cardiology, University of Colorado Anschutz Medical Campus, Aurora (F.A.M.); Division of Cardiology, Federal University of Sergipe, and the Clínica e Hospital São Lucas, Aracaju, Brazil (J.A.S.B.-F.); Department of Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain (H.B.); and University of Kansas City-Missouri and Saint Luke's Mid America Heart Institute, Kansas City (J.A.S.).
Basmah
B
Safdar
From Section of Cardiovascular Medicine, Department of Internal Medicine (E.S.S., J.P.C., A.J.L., J.F.L., R.P.D., K.M., H.M.K.), Section of General Internal Medicine, Department of Internal Medicine (C.P.G., S.I.C.), Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine (L.A.C., C.P.G., H.M.K.), Yale Cardiovascular Research Group, Department of Internal Medicine (A.J.L.), and Department of Emergency Medicine (G.D., B.S.), Yale School of Medicine, New Haven, CT; Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, CT (E.S.S., S.Z., K.M.S., J.P.C., J.A.S.B.-F., J.F.L., H.B., R.P.D., K.M., H.M.K.); Department of Health Policy and Management, Yale School of Public Health, New Haven, CT (L.A.C., H.M.K.); Division of Cardiology, University of Colorado Anschutz Medical Campus, Aurora (F.A.M.); Division of Cardiology, Federal University of Sergipe, and the Clínica e Hospital São Lucas, Aracaju, Brazil (J.A.S.B.-F.); Department of Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain (H.B.); and University of Kansas City-Missouri and Saint Luke's Mid America Heart Institute, Kansas City (J.A.S.).
Rachel P
RP
Dreyer
From Section of Cardiovascular Medicine, Department of Internal Medicine (E.S.S., J.P.C., A.J.L., J.F.L., R.P.D., K.M., H.M.K.), Section of General Internal Medicine, Department of Internal Medicine (C.P.G., S.I.C.), Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine (L.A.C., C.P.G., H.M.K.), Yale Cardiovascular Research Group, Department of Internal Medicine (A.J.L.), and Department of Emergency Medicine (G.D., B.S.), Yale School of Medicine, New Haven, CT; Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, CT (E.S.S., S.Z., K.M.S., J.P.C., J.A.S.B.-F., J.F.L., H.B., R.P.D., K.M., H.M.K.); Department of Health Policy and Management, Yale School of Public Health, New Haven, CT (L.A.C., H.M.K.); Division of Cardiology, University of Colorado Anschutz Medical Campus, Aurora (F.A.M.); Division of Cardiology, Federal University of Sergipe, and the Clínica e Hospital São Lucas, Aracaju, Brazil (J.A.S.B.-F.); Department of Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain (H.B.); and University of Kansas City-Missouri and Saint Luke's Mid America Heart Institute, Kansas City (J.A.S.).
Karthik
K
Murugiah
From Section of Cardiovascular Medicine, Department of Internal Medicine (E.S.S., J.P.C., A.J.L., J.F.L., R.P.D., K.M., H.M.K.), Section of General Internal Medicine, Department of Internal Medicine (C.P.G., S.I.C.), Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine (L.A.C., C.P.G., H.M.K.), Yale Cardiovascular Research Group, Department of Internal Medicine (A.J.L.), and Department of Emergency Medicine (G.D., B.S.), Yale School of Medicine, New Haven, CT; Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, CT (E.S.S., S.Z., K.M.S., J.P.C., J.A.S.B.-F., J.F.L., H.B., R.P.D., K.M., H.M.K.); Department of Health Policy and Management, Yale School of Public Health, New Haven, CT (L.A.C., H.M.K.); Division of Cardiology, University of Colorado Anschutz Medical Campus, Aurora (F.A.M.); Division of Cardiology, Federal University of Sergipe, and the Clínica e Hospital São Lucas, Aracaju, Brazil (J.A.S.B.-F.); Department of Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain (H.B.); and University of Kansas City-Missouri and Saint Luke's Mid America Heart Institute, Kansas City (J.A.S.).
John A
JA
Spertus
From Section of Cardiovascular Medicine, Department of Internal Medicine (E.S.S., J.P.C., A.J.L., J.F.L., R.P.D., K.M., H.M.K.), Section of General Internal Medicine, Department of Internal Medicine (C.P.G., S.I.C.), Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine (L.A.C., C.P.G., H.M.K.), Yale Cardiovascular Research Group, Department of Internal Medicine (A.J.L.), and Department of Emergency Medicine (G.D., B.S.), Yale School of Medicine, New Haven, CT; Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, CT (E.S.S., S.Z., K.M.S., J.P.C., J.A.S.B.-F., J.F.L., H.B., R.P.D., K.M., H.M.K.); Department of Health Policy and Management, Yale School of Public Health, New Haven, CT (L.A.C., H.M.K.); Division of Cardiology, University of Colorado Anschutz Medical Campus, Aurora (F.A.M.); Division of Cardiology, Federal University of Sergipe, and the Clínica e Hospital São Lucas, Aracaju, Brazil (J.A.S.B.-F.); Department of Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain (H.B.); and University of Kansas City-Missouri and Saint Luke's Mid America Heart Institute, Kansas City (J.A.S.). harlan.krumholz@yale.edu.
Harlan M
HM
Krumholz
D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000465:Algorithms; D000784:Aortic Dissection / Q000150:complications; D002965:Classification / Q000379:methods; D003327:Coronary Disease / Q000145:classification / Q000150:complications / Q000473:pathology; D003935:Diagnostic Techniques, Cardiovascular; D005260:Female; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D009203:Myocardial Infarction / Q000145:classification* / Q000175:diagnosis / Q000209:etiology; D009206:Myocardium / Q000378:metabolism; D010101:Oxygen Consumption; D010641:Phenotype; D058226:Plaque, Atherosclerotic / Q000150:complications; D011446:Prospective Studies; D015203:Reproducibility of Results; D012307:Risk Factors; D012737:Sex Factors; D016896:Treatment Outcome; D055815:Young Adult
classification; myocardial infarction; sex characteristics