Incidence, Frequency, and Clinical Characteristics of Type 3 Myocardial Infarction in Clinical Practice.
Cardiac death in a patient with symptoms and electrocardiographic changes indicative of myocardial ischemia but without available measurements of cardiac biomarkers is designated a type 3 myocardial infarction. We wanted to investigate the incidence, the frequency, and the characteristics of patients diagnosed as type 3 myocardial infarction.



The occurrence of deaths in a well-defined geographic region was retrieved from the Danish Civil Registration System during a 1-year period from 2010 to 2011. Complementary data concerning causes of deaths were obtained from the Danish Register of Causes of Death, and ambulance and hospital patient files. Adjudication of the diagnosis was done by 2 local experts and one external senior cardiologist.



A total of 2766 of the 246,723 adult residents in the region had died. A type 3 myocardial infarction was diagnosed in 18 individuals, corresponding to an annual incidence of 7.3/100,000 person-years. During the same 1-year period, 488 patients had other types of myocardial infarction implying a 3.6% frequency of type 3 myocardial infarction (18 of 506) among all myocardial infarctions.



Type 3 myocardial infarction is a rare observation in clinical practice with an annual incidence below 10/100,000 person-years and a frequency of 3%-4% among all types of myocardial infarction. If autopsy data are included, the number of type 3 myocardial infarctions will increase.
Department of Cardiology, Odense University Hospital, Denmark.
Nikolaj
N
Jangaard
Department of Cardiology, Odense University Hospital, Denmark.
Laura
L
Sarkisian
Department of Cardiology, Odense University Hospital, Denmark.
Lotte
L
Saaby
Mobile Emergency Care Unit, Department of Anesthesiology and Intensive Care, Odense University Hospital, Denmark.
Søren
S
Mikkelsen
Department of Emergency Medicine, Odense University Hospital, Denmark.
Anne Marie
AM
Lassen
Institute of Pathology, Odense University Hospital, Denmark.
Niels
N
Marcussen
Institute of Forensic Medicine, Odense University Hospital, Denmark.
Jørgen L
JL
Thomsen
Department of Cardiology, Odense University Hospital, Denmark.
Axel C P
ACP
Diederichsen
Department of Cardiology, Aarhus University Hospital, Denmark.
Kristian
K
Thygesen
Department of Cardiology, Odense University Hospital, Denmark. Electronic address: Hans.mickley@rsyd.dk.
Hans
H
Mickley
D000368:Aged; D001344:Autopsy; D015415:Biomarkers / Q000097:blood; D003718:Denmark / Q000453:epidemiology; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D008297:Male; D009203:Myocardial Infarction / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D012189:Retrospective Studies; D019210:Troponin I / Q000097:blood
D015415:Biomarkers; D019210:Troponin I
Mortality/survival; Quality and outcomes; Resource utilization; Syncope