title: Comparison between type-2 and type-1 myocardial infarction: clinical features, treatment strategies and outcomes.
abstract: OBJECTIVE
  To assess the differences in incidence, clinical features, current treatment strategies and outcome in patients with type-2 vs. type-1 acute myocardial infarction (AMI).
  
  
  METHODS
  We included 824 consecutive patients with a diagnosis of type-1 or type-2 AMI. During index hospitalization, clinical features and treatment strategies were collected in detail. At 1-year follow-up, mortality, stroke, non-fatal myocardial infarction and major bleeding were recorded.
  
  
  RESULTS
  Type-1 AMI was present in 707 (86%) of the cases while 117 (14%) were classified as type-2. Patients with type-2 AMI were more frequently female and had higher co-morbidities such as diabetes, previous non-ST segment elevation acute coronary syndromes, impaired renal function, anaemia, atrial fibrillation and malignancy. However, preserved left ventricular ejection fraction and normal coronary arteries were more frequently seen, an invasive treatment was less common, and anti-platelet medications, statins and beta-blockers were less prescribed in patients with type-2 AMI. At 1-year follow-up, type-2 AMI was associated with a higher crude mortality risk (HR: 1.75, 95% CI: 1.14-2.68; P = 0.001), but this association did not remain significant after multivariable adjustment (P = 0.785). Furthermore, we did not find type-2 AMI to be associated with other clinical outcomes.
  
  
  CONCLUSIONS
  In this real-life population, compared with type-1, type-2 AMI were predominantly women and had more co-morbidities. Invasive treatment strategies and cardioprotective medications were less used in type-2, while the 1-year clinical outcomes were similar.
authors.affiliation: Department of Internal Medicine, Hospital de la Vega Lorenzo Guirao, Cieza, Spain.
authors.forename: Angel
authors.initials: A
authors.lastname: López-Cuenca
authors.affiliation: Division of Cardiology, University Hospital Virgen de la Arrixaca, School of Medicine, IMIB, Murcia, Spain.
authors.forename: Miriam
authors.initials: M
authors.lastname: Gómez-Molina
authors.affiliation: Division of Cardiology, University Hospital Virgen de la Arrixaca, School of Medicine, IMIB, Murcia, Spain.
authors.forename: Pedro J
authors.initials: PJ
authors.lastname: Flores-Blanco
authors.affiliation: Division of Cardiology, University Hospital Virgen de la Arrixaca, School of Medicine, IMIB, Murcia, Spain.
authors.forename: Marianela
authors.initials: M
authors.lastname: Sánchez-Martínez
authors.affiliation: Department of Biochemistry, University Hospital Virgen de la Arrixaca, School of Medicine, IMIB, Murcia, Spain.
authors.forename: Andrea
authors.initials: A
authors.lastname: García-Narbon
authors.affiliation: Department of Biochemistry, University Hospital Virgen de la Arrixaca, School of Medicine, IMIB, Murcia, Spain.
authors.forename: Ignacio
authors.initials: I
authors.lastname: De Las Heras-Gómez
authors.affiliation: Division of Cardiology, University Hospital Virgen de la Arrixaca, School of Medicine, IMIB, Murcia, Spain.
authors.forename: María J
authors.initials: MJ
authors.lastname: Sánchez-Galian
authors.affiliation: Division of Cardiology, University Hospital Virgen de la Arrixaca, School of Medicine, IMIB, Murcia, Spain.
authors.forename: Esther
authors.initials: E
authors.lastname: Guerrero-Pérez
authors.affiliation: Division of Cardiology, University Hospital Virgen de la Arrixaca, School of Medicine, IMIB, Murcia, Spain; Department of Internal Medicine, University of Murcia, Murcia, Spain.
authors.forename: Mariano
authors.initials: M
authors.lastname: Valdés
authors.affiliation: Division of Cardiology, University Hospital Virgen de la Arrixaca, School of Medicine, IMIB, Murcia, Spain; Department of Internal Medicine, University of Murcia, Murcia, Spain.
authors.forename: Sergio
authors.initials: S
authors.lastname: Manzano-Fernández
keywords: Coronary vessels; Follow-up studies; Myocardial infarction