Type 2 MI and Myocardial Injury in the Era of High-sensitivity Troponin

Troponin has been the cornerstone of the definition of MI since its introduction to clinical practice. High-sensitivity troponin has allowed clinicians to detect degrees of myocardial damage at orders of magnitude smaller than previously and is challenging the definitions of MI, with implications fo...

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Main Authors: Rifly Rafiudeen, Peter Barlis, Harvey D White, William van Gaal
Format: Article
Language:English
Published: Radcliffe Medical Media 2022-02-01
Series:European Cardiology Review
Online Access:https://www.ecrjournal.com/articleindex/ecr.2021.42
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author Rifly Rafiudeen
Peter Barlis
Harvey D White
William van Gaal
author_facet Rifly Rafiudeen
Peter Barlis
Harvey D White
William van Gaal
author_sort Rifly Rafiudeen
collection DOAJ
description Troponin has been the cornerstone of the definition of MI since its introduction to clinical practice. High-sensitivity troponin has allowed clinicians to detect degrees of myocardial damage at orders of magnitude smaller than previously and is challenging the definitions of MI, with implications for patient management and prognosis. Detection and diagnosis are no doubt enhanced by the greater sensitivity afforded by these markers, but perhaps at the expense of specificity and clarity. This review focuses on the definitions, pathophysiology, prognosis, prevention and management of type 2 MI and myocardial injury. The five types of MI were first defined in 2007 and were recently updated in 2018 in the fourth universal definition of MI. The authors explore how this pathophysiological classification is used in clinical practice, and discuss some of the unanswered questions in this era of availability of high-sensitivity troponin.
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publishDate 2022-02-01
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series European Cardiology Review
spelling doaj-art-673206bcae8848e680fcfcd3d0b3eb4a2025-08-20T02:39:22ZengRadcliffe Medical MediaEuropean Cardiology Review1758-37561758-37642022-02-011710.15420/ecr.2021.42Type 2 MI and Myocardial Injury in the Era of High-sensitivity TroponinRifly Rafiudeen0Peter Barlis1Harvey D White2William van Gaal3Department of Cardiology, The Northern Hospital, Melbourne, Australia; Department of Medicine, The University of Melbourne, Melbourne, AustraliaDepartment of Cardiology, The Northern Hospital, Melbourne, Australia; Department of Medicine, The University of Melbourne, Melbourne, AustraliaGreen Lane Cardiovascular Service, Auckland City Hospital, Auckland, New ZealandDepartment of Cardiology, The Northern Hospital, Melbourne, Australia; Department of Medicine, The University of Melbourne, Melbourne, AustraliaTroponin has been the cornerstone of the definition of MI since its introduction to clinical practice. High-sensitivity troponin has allowed clinicians to detect degrees of myocardial damage at orders of magnitude smaller than previously and is challenging the definitions of MI, with implications for patient management and prognosis. Detection and diagnosis are no doubt enhanced by the greater sensitivity afforded by these markers, but perhaps at the expense of specificity and clarity. This review focuses on the definitions, pathophysiology, prognosis, prevention and management of type 2 MI and myocardial injury. The five types of MI were first defined in 2007 and were recently updated in 2018 in the fourth universal definition of MI. The authors explore how this pathophysiological classification is used in clinical practice, and discuss some of the unanswered questions in this era of availability of high-sensitivity troponin.https://www.ecrjournal.com/articleindex/ecr.2021.42
spellingShingle Rifly Rafiudeen
Peter Barlis
Harvey D White
William van Gaal
Type 2 MI and Myocardial Injury in the Era of High-sensitivity Troponin
European Cardiology Review
title Type 2 MI and Myocardial Injury in the Era of High-sensitivity Troponin
title_full Type 2 MI and Myocardial Injury in the Era of High-sensitivity Troponin
title_fullStr Type 2 MI and Myocardial Injury in the Era of High-sensitivity Troponin
title_full_unstemmed Type 2 MI and Myocardial Injury in the Era of High-sensitivity Troponin
title_short Type 2 MI and Myocardial Injury in the Era of High-sensitivity Troponin
title_sort type 2 mi and myocardial injury in the era of high sensitivity troponin
url https://www.ecrjournal.com/articleindex/ecr.2021.42
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