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Stankovic I, Zivanic A, Vranic I, Neskovic AN. Correlations and discrepancies between cardiac ultrasound, clinical diagnosis and the autopsy findings in early deceased patients with suspected cardiovascular emergencies. THE INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING 2024:10.1007/s10554-024-03107-w. [PMID: 38652394 DOI: 10.1007/s10554-024-03107-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 04/03/2024] [Indexed: 04/25/2024]
Abstract
Cardiac ultrasound (CUS), either focused cardiac ultrasound (FoCUS) or emergency echocardiography, is frequently used in cardiovascular (CV) emergencies. We assessed correlations and discrepancies between CUS, clinical diagnosis and the autopsy findings in early deceased patients with suspected CV emergencies. We retrospectively analysed clinical and autopsy data of 131 consecutive patients who died within 24 h of hospital admission. The type of CUS and its findings were analysed in relation to the clinical and autopsy diagnoses. CUS was performed in 58% of patients - FoCUS in 83%, emergency echocardiography in 12%, and both types of CUS in 5% of cases. CUS was performed more frequently in patients without a history of CV disease (64 vs. 40%, p = 0.08) and when the time between admission and death was longer (6 vs. 2 h, p = 0.021). In 7% of patients, CUS was inconclusive. In 10% of patients, the ante-mortem cause of death could not be determined, while discrepancies between the clinical and post-mortem diagnosis were found in 26% of cases. In the multivariate logistic regression model, only conclusive CUS [odds ratio (OR) 2.76, 95% confidence interval (CI) 1.30-7.39, p = 0.044] and chest pain at presentation (OR 30.19, 95%CI 5.65 -161.22, p < 0.001) were independently associated with congruent clinical and autopsy diagnosis. In a tertiary university hospital, FoCUS was used more frequently than emergency echocardiography in critically ill patients with suspected cardiac emergencies. Chest pain at presentation and a conclusive CUS were associated with concordant clinical and autopsy diagnoses.
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Affiliation(s)
- Ivan Stankovic
- Department of Cardiology, Clinical Hospital Centre Zemun, Vukova 9, Belgrade, 11080, Serbia.
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
| | - Aleksandra Zivanic
- Department of Cardiology, Clinical Hospital Centre Zemun, Vukova 9, Belgrade, 11080, Serbia
| | - Ivona Vranic
- Department of Cardiology, Clinical Hospital Centre Zemun, Vukova 9, Belgrade, 11080, Serbia
| | - Aleksandar N Neskovic
- Department of Cardiology, Clinical Hospital Centre Zemun, Vukova 9, Belgrade, 11080, Serbia
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
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2
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Chen Y, Weng C, Wu J, Tang Y, Li Z, Wen Q, Sun X, Wu M, Peng Z, Luo X, Yuan H, Lu Y, Huang W, Cai J. Clinical characteristics and prognosis differences between isolated right and left ventricular myocardial infarction in the Chinese population: a retrospective study. PeerJ 2023; 11:e14959. [PMID: 36874976 PMCID: PMC9983429 DOI: 10.7717/peerj.14959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 02/05/2023] [Indexed: 03/04/2023] Open
Abstract
Background and aims Acute myocardial infarction (AMI) is divided into left ventricular myocardial infarction (LVMI) and right ventricular myocardial infarction (RVMI) according to the regions of myocardial ischemic necrosis. Clinical characteristics, treatment strategies, and prognosis differences between isolated RVMI and LVMI have not been well characterized. This study aimed to explore this difference of patients with isolated RVMI and LVMI. Methods This retrospective cohort study included 3,506 patients hospitalized with coronary angiography diagnosed type 1 myocardial infarction (MI). Characteristics of admission and treatment strategies were compared in patients with isolated RVMI and LVMI. COX proportional hazards models with and without inverse probability of treatment weighting (IPTW) adjustment were performed to estimate the difference in all-cause and cardiovascular mortality between the two groups. Results In this retrospective study, we found the frequency of isolated RVMI was significantly lower in the population than that of isolated LVMI (406 (11.6%) vs 3,100 (88.4%)). Patients with isolated RVMI have similar age, sex, and comorbidities to the patients with isolated LVMI. However, patients with isolated RVMI have lower heart rate and blood pressure, but higher rates of cardiogenic shock and atrioventricular block. It is noteworthy that patients with isolated RVMI are more likely to be complicated with the multivessel lesion. Patients with isolated RVMI have lower risk of all-cause mortality (HR 0.36; 95% CI [0.24-0.54], p < 0.001) and cardiovascular mortality (HR 0.37; 95% CI [0.22-0.62], p < 0.001) than patients with isolated LVMI. Conclusions This study showed that patients with isolated RVMI and LVMI have similar baseline characteristics. However, the clinical manifestations were different in the isolated RVMI and LVMI patients. This study revealed a better prognosis of isolated RVMI patients compared to isolated LVMI, which indicates the ischemic region could be considered in AMI risk stratification models for better assessment of risk for adverse clinical events.
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Affiliation(s)
- Yuanyuan Chen
- Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Chunyan Weng
- Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Junru Wu
- Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yan Tang
- Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Zhengxin Li
- Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Qing Wen
- Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xuejing Sun
- Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Mingxing Wu
- Department of Cardiology, Xiangtan Central Hospital, Xiangtan, Hunan, China
| | - Zhiliu Peng
- Department of Cardiology, Xiangtan Central Hospital, Xiangtan, Hunan, China
| | - Xiying Luo
- Department of Cardiology, The First Affiliated Hospital, University of South China, Hengyang, Hunan, China
| | - Hong Yuan
- The Center of Clinical Pharmacology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yao Lu
- The Center of Clinical Pharmacology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Wei Huang
- Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jingjing Cai
- Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China.,The Center of Clinical Pharmacology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
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Rebordosa C, Plana E, Rubino A, Aguado J, Martinez D, Lei A, Daoud S, Saigi-Morgui N, Perez-Gutthann S, Rivero-Ferrer E. Risk Assessment of Acute Myocardial Infarction and Stroke Associated with Long-Acting Muscarinic Antagonists, Alone or in Combination, versus Long-Acting beta2-Agonists. Int J Chron Obstruct Pulmon Dis 2022; 17:1715-1733. [PMID: 35941901 PMCID: PMC9356604 DOI: 10.2147/copd.s363997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 07/21/2022] [Indexed: 11/29/2022] Open
Abstract
Background The long-acting muscarinic antagonist (LAMA) aclidinium was approved in Europe in 2012 to relieve symptoms in adult patients with chronic obstructive pulmonary disease (COPD). A post-authorization safety study was initiated to assess potential cardiovascular risks associated with LAMAs versus long-acting beta2-agonists. Purpose To estimate incidence rates and adjusted incidence rate ratios (IRRs) for acute myocardial infarction (AMI), stroke, and major adverse cardiac events (MACE) in new users of aclidinium, aclidinium/formoterol, tiotropium, other LAMA, long-acting beta-agonists/inhaled corticosteroids (LABA/ICS), and LAMA/LABA compared with initiators of LABA. Patients and Methods This population-based cohort study included patients with COPD aged ≥40 years initiating COPD medications in the UK Clinical Practice Research Datalink (CPRD) Aurum database from 2012 to 2019. Poisson regression models were used to estimate the IRR for AMI, stroke, and MACE in users of COPD medications versus LABA, adjusting for clinically relevant covariables. Results The study included 11,121 new users of aclidinium, 4804 of aclidinium/formoterol, 56,198 of tiotropium, 23,856 of other LAMA, 17,450 of LAMA/LABA, 70,289 of LABA/ICS, and 13,716 of LABA. During periods of continuous medication use after initiation (current use), crude incidence rates per 1000 person-years for AMI ranged from 8.7 (aclidinium/formoterol) to 12.4 (LAMA/LABA), for stroke ranged from 4.8 (aclidinium/formoterol) to 7.2 (LAMA/LABA), and for MACE ranged from 13.5 (aclidinium/formoterol) to 19.3 (LAMA/LABA). Using LABA as reference, adjusted IRRs [95% confidence intervals] were close to 1 for all study drugs for AMI (lowest for aclidinium/formoterol, 0.95 [0.60–1.52], and highest for LAMA/LABA, 1.23 [0.91–1.67]), stroke (lowest for aclidinium/formoterol, 0.64 [0.39–1.06], and highest for tiotropium, 1.02 [0.81–1.27] for tiotropium) and for MACE (lowest for aclidinium, 0.93 [0.75–1.16], and highest for LAMA/LABA, 1.24 [0.97–1.59]). Conclusion Risks of AMI, stroke, and MACE in current users of aclidinium, aclidinium/formoterol, tiotropium, other LAMA, LAMA/LABA, or LABA/ICS were similar to the risks among current users of LABA.
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Affiliation(s)
- Cristina Rebordosa
- Department of Epidemiology and Risk Management, RTI Health Solutions, Barcelona, Spain
- Correspondence: Cristina Rebordosa, RTI Health Solutions, Department of Epidemiology and Risk Management, Av. Diagonal, 605, 9-1, Barcelona, 08028, Spain, Tel +34.93.362.2807, Fax +34.93.760.8507, Email
| | - Estel Plana
- Department of Biometrics, RTI Health Solutions, Barcelona, Spain
| | - Annalisa Rubino
- Epidemiology, Respiratory and Immunology, AstraZeneca, Cambridge, UK
| | - Jaume Aguado
- Department of Biometrics, RTI Health Solutions, Barcelona, Spain
| | - David Martinez
- Department of Biometrics, RTI Health Solutions, Barcelona, Spain
| | | | - Sami Daoud
- BioPharmaceuticals Research and Development, Late-Stage Development Respiratory and Immunology, AstraZeneca, Gaithersburg, MD, USA
| | - Nuria Saigi-Morgui
- Department of Epidemiology and Risk Management, RTI Health Solutions, Barcelona, Spain
| | - Susana Perez-Gutthann
- Department of Epidemiology and Risk Management, RTI Health Solutions, Barcelona, Spain
| | - Elena Rivero-Ferrer
- Department of Epidemiology and Risk Management, RTI Health Solutions, Barcelona, Spain
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Domienik-Karłowicz J, Kupczyńska K, Michalski B, Kapłon-Cieślicka A, Darocha S, Dobrowolski P, Wybraniec M, Wańha W, Jaguszewski M. Fourth universal definition of myocardial infarction. Selected messages from the European Society of Cardiology document and lessons learned from the new guidelines on ST-segment elevation myocardial infarction and non-ST-segment elevation-acute coronary syndrome. Cardiol J 2021; 28:195-201. [PMID: 33843035 DOI: 10.5603/cj.a2021.0036] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Accepted: 03/17/2021] [Indexed: 11/25/2022] Open
Affiliation(s)
- Justyna Domienik-Karłowicz
- Department of Internal Medicine and Cardiology, Medical University of Warsaw, Poland. .,"Club 30", Polish Cardiac Society, Poland.
| | - Karolina Kupczyńska
- Department of Cardiology, W. Bieganski Hospital, Medical University of Lodz, Lodz, Poland.,"Club 30", Polish Cardiac Society, Poland
| | - Błażej Michalski
- Department of Cardiology, W. Bieganski Hospital, Medical University of Lodz, Lodz, Poland.,"Club 30", Polish Cardiac Society, Poland
| | - Agnieszka Kapłon-Cieślicka
- Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.,"Club 30", Polish Cardiac Society, Poland
| | - Szymon Darocha
- Department of Pulmonary Circulation, Thromboembolic Diseases and Cardiology, Centre of Postgraduate Medical Education, European Health Centre, Otwock, Poland.,"Club 30", Polish Cardiac Society, Poland
| | - Piotr Dobrowolski
- Department of Hypertension, National Institute of Cardiology, Warsaw, Poland.,"Club 30", Polish Cardiac Society, Poland
| | - Maciej Wybraniec
- First Department of Cardiology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland.,"Club 30", Polish Cardiac Society, Poland
| | - Wojciech Wańha
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland.,"Club 30", Polish Cardiac Society, Poland
| | - Miłosz Jaguszewski
- First Department of Cardiology, Medical University of Gdansk, Gdansk, Poland.,"Club 30", Polish Cardiac Society, Poland
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Gopar-Nieto R, Araiza-Garaygordobil D, Raymundo-Martínez GI, Martínez-Amezcua P, Cabello-López A, Manzur-Sandoval D, Chávez-Gómez NL, Loáisiga-Sáenz AE, Baeza-Herrera LA, Dattoli-García CA, Gallardo-Grajeda LA, Jackson-Pedroza CN, Salas-Teles B, Arias-Mendoza A. Demographic description and outcomes of a metropolitan network for myocardial infarction treatment. ARCHIVOS DE CARDIOLOGIA DE MEXICO 2021; 91:167-177. [PMID: 33471783 PMCID: PMC8295868 DOI: 10.24875/acm.20000133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 04/12/2020] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE The objective of the study was to describe the myocardial infarction treatment network and compare in-hospital mortality in patients undergoing either primary angioplasty or pharmacoinvasive strategy in Mexico City and a broad metropolitan area. METHODS Cohort study including patients with ST-elevation myocardial infarction. We recorded demographic and clinical data, laboratory tests and in-hospital mortality in patients that underwent primary angioplasty and pharmacoinvasive strategy. Kaplan-Meier analysis was used to assess mortality and Cox-regression assessed mortality risk factors. RESULTS Three hundred forty patients from a network of 60 hospitals and 9 states were analyzed. Of the total population, 166 were treated with pharmacoinvasive strategy and 174 with primary angioplasty. Door to thrombolytic time was 54 min and door to wire crossing time was 72.5 min; no differences in total ischemia time were demonstrated. No differences for in-hospital mortality (6.3% vs. 5.4%, p = 0.49) were found when comparing pharmacoinvasive and primary angioplasty groups. The main predictors for in-hospital mortality were: glucose > 180 mg/dl (HR 3.73), total ischemia time > 420 min (HR 3.18), heart rate > 90 bpm (HR 5.46), Killip and Kimball > II (HR 11.03), and left ventricle ejection fraction < 40% (HR 3.21). CONCLUSIONS This myocardial infarction network covers a large area and constitutes one of the biggest in the world. There were no differences regarding in-hospital mortality between pharmacoinvasive strategy and primary angioplasty. Pharmacoinvasive strategy is an effective and safe option for prompt reperfusion in Mexico.
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Affiliation(s)
- Rodrigo Gopar-Nieto
- Coronary Unit, Instituto Nacional de Cardiología “Ignacio Chávez”, Mexico City, Mexico
| | | | | | - Pablo Martínez-Amezcua
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Alejandro Cabello-López
- Unidad de Investigación de Salud en el Trabajo, Centro Médico Nacional Siglo XXI, Mexico City, Mexico
| | | | - Nancy L. Chávez-Gómez
- Coronary Unit, Instituto Nacional de Cardiología “Ignacio Chávez”, Mexico City, Mexico
| | | | - Luis A. Baeza-Herrera
- Coronary Unit, Instituto Nacional de Cardiología “Ignacio Chávez”, Mexico City, Mexico
| | | | | | | | - Brandon Salas-Teles
- Coronary Unit, Instituto Nacional de Cardiología “Ignacio Chávez”, Mexico City, Mexico
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Michaud K, Basso C, d'Amati G, Giordano C, Kholová I, Preston SD, Rizzo S, Sabatasso S, Sheppard MN, Vink A, van der Wal AC. Diagnosis of myocardial infarction at autopsy: AECVP reappraisal in the light of the current clinical classification. Virchows Arch 2020; 476:179-194. [PMID: 31522288 PMCID: PMC7028821 DOI: 10.1007/s00428-019-02662-1] [Citation(s) in RCA: 65] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 08/21/2019] [Accepted: 08/28/2019] [Indexed: 01/24/2023]
Abstract
Ischemic heart disease is one of the leading causes of morbidity and death worldwide. Consequently, myocardial infarctions are often encountered in clinical and forensic autopsies, and diagnosis can be challenging, especially in the absence of an acute coronary occlusion. Precise histopathological identification and timing of myocardial infarction in humans often remains uncertain while it can be of crucial importance, especially in a forensic setting when third person involvement or medical responsibilities are in question. A proper post-mortem diagnosis requires not only up-to-date knowledge of the ischemic coronary and myocardial pathology, but also a correct interpretation of such findings in relation to the clinical scenario of the deceased. For these reasons, it is important for pathologists to be familiar with the different clinically defined types of myocardial infarction and to discriminate myocardial infarction from other forms of myocardial injury. This article reviews present knowledge and post-mortem diagnostic methods, including post-mortem imaging, to reveal the different types of myocardial injury and the clinical-pathological correlations with currently defined types of myocardial infarction.
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Affiliation(s)
- Katarzyna Michaud
- University Center of Legal Medicine Lausanne - Geneva, Lausanne University Hospital and University of Lausanne, Chemin de la Vulliette 4, CH - 1000, Lausanne 25, Switzerland.
| | - Cristina Basso
- Cardiovascular Pathology, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Giulia d'Amati
- Department of Radiological, Oncological and Pathological Sciences, Sapienza, University of Rome, Rome, Italy
| | - Carla Giordano
- Department of Radiological, Oncological and Pathological Sciences, Sapienza, University of Rome, Rome, Italy
| | - Ivana Kholová
- Pathology, Fimlab Laboratories and Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | | | - Stefania Rizzo
- Cardiovascular Pathology, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Sara Sabatasso
- University Center of Legal Medicine Lausanne-Geneva, Geneva University Hospital and University of Geneva, Geneva, Switzerland
| | - Mary N Sheppard
- Department of Cardiovascular Pathology, Cardiology Clinical Academic Group, Molecular and Clinical Sciences Research Institute, St George's Medical School, London, UK
| | - Aryan Vink
- University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Allard C van der Wal
- Amsterdam UMC, Academic Medical Center, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands.
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Buja LM, Zehr B, Lelenwa L, Ogechukwu E, Zhao B, Dasgupta A, Barth RF. Clinicopathological complexity in the application of the universal definition of myocardial infarction. Cardiovasc Pathol 2019; 44:107153. [PMID: 31760238 DOI: 10.1016/j.carpath.2019.107153] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 08/28/2019] [Accepted: 09/09/2019] [Indexed: 12/13/2022] Open
Abstract
A universal definition of myocardial infarction (UDMI) has been established, periodically updated, and refined over the past twenty years. The primary purpose of the UDMI is to bring uniformity and accuracy to clinical diagnosis. Herein, a review and analysis of the UDMI is presented with emphasis on clinicopathological correlation. Determination of the presence of myocardial injury is based on the detection of abnormal serum cardiac biomarkers, particularly cardiac troponin (cTn), and in the current fourth iteration of the UDMI, high sensitivity (hs)-cTn. Differentiation of myocardial infarction from other causes of myocardial injury requires the documentation of clinical evidence of myocardial ischemia. In this review, difficulties in applying the UDMI in actual practice are discussed, based on the experience and perspective of those of us who face these problems as part of our own practice of pathology. The complexity in application of the UDMI is highlighted by the presentation of five illustrative cases involving the differential diagnosis of myocardial injury and myocardial infarction due to atherothrombotic and nonatherothrombotic coronary artery disease. The cases include myocardial infarction due to severe coronary atherosclerosis, supply-demand mismatch, coronary artery dissection associated with an eosinophilic coronary periarteritis, and coronary thromboembolism, and a case with a differential diagnosis of myocarditis and myocardial infarction. These cases illustrate how pathological findings can contribute to more accurate application of the UDMI and how, when critically applied, the UDMI can be used to better characterize myocardial infarcts in clinical practice.
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Affiliation(s)
- Louis Maximilian Buja
- Department of Pathology and Laboratory Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston (UT Health), United States.
| | - Bradley Zehr
- Department of Pathology, The Ohio State University (OSU), United States
| | - Laura Lelenwa
- Department of Pathology and Laboratory Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston (UT Health), United States
| | - Eze Ogechukwu
- Department of Pathology, The Ohio State University (OSU), United States
| | - Bihong Zhao
- Department of Pathology and Laboratory Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston (UT Health), United States
| | - Amitava Dasgupta
- Department of Pathology and Laboratory Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston (UT Health), United States
| | - Rolf F Barth
- Department of Pathology, The Ohio State University (OSU), United States
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Thygesen K, Alpert JS, Jaffe AS, Chaitman BR, Bax JJ, Morrow DA, White HD. Fourth Universal Definition of Myocardial Infarction (2018). Circulation 2019; 138:e618-e651. [PMID: 30571511 DOI: 10.1161/cir.0000000000000617] [Citation(s) in RCA: 1633] [Impact Index Per Article: 326.6] [Reference Citation Analysis] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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9
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Thygesen K, Alpert JS, Jaffe AS, Chaitman BR, Bax JJ, Morrow DA, White HD. Fourth Universal Definition of Myocardial Infarction (2018). J Am Coll Cardiol 2018; 72:2231-2264. [PMID: 30153967 DOI: 10.1016/j.jacc.2018.08.1038] [Citation(s) in RCA: 2011] [Impact Index Per Article: 335.2] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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10
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Thygesen K, Alpert JS, Jaffe AS, Chaitman BR, Bax JJ, Morrow DA, White HD, Thygesen K, Alpert JS, Jaffe AS, Chaitman BR, Bax JJ, Morrow DA, White HD, Mickley H, Crea F, Van de Werf F, Bucciarelli-Ducci C, Katus HA, Pinto FJ, Antman EM, Hamm CW, De Caterina R, Januzzi JL, Apple FS, Alonso Garcia MA, Underwood SR, Canty JM, Lyon AR, Devereaux PJ, Zamorano JL, Lindahl B, Weintraub WS, Newby LK, Virmani R, Vranckx P, Cutlip D, Gibbons RJ, Smith SC, Atar D, Luepker RV, Robertson RM, Bonow RO, Steg PG, O’Gara PT, Fox KAA, Hasdai D, Aboyans V, Achenbach S, Agewall S, Alexander T, Avezum A, Barbato E, Bassand JP, Bates E, Bittl JA, Breithardt G, Bueno H, Bugiardini R, Cohen MG, Dangas G, de Lemos JA, Delgado V, Filippatos G, Fry E, Granger CB, Halvorsen S, Hlatky MA, Ibanez B, James S, Kastrati A, Leclercq C, Mahaffey KW, Mehta L, Müller C, Patrono C, Piepoli MF, Piñeiro D, Roffi M, Rubboli A, Sharma S, Simpson IA, Tendera M, Valgimigli M, van der Wal AC, Windecker S, Chettibi M, Hayrapetyan H, Roithinger FX, Aliyev F, Sujayeva V, Claeys MJ, Smajić E, Kala P, Iversen KK, El Hefny E, Marandi T, Porela P, Antov S, Gilard M, Blankenberg S, Davlouros P, Gudnason T, Alcalai R, Colivicchi F, Elezi S, Baitova G, Zakke I, Gustiene O, Beissel J, Dingli P, Grosu A, Damman P, Juliebø V, Legutko J, Morais J, Tatu-Chitoiu G, Yakovlev A, Zavatta M, Nedeljkovic M, Radsel P, Sionis A, Jemberg T, Müller C, Abid L, Abaci A, Parkhomenko A, Corbett S. Fourth universal definition of myocardial infarction (2018). Eur Heart J 2018; 40:237-269. [DOI: 10.1093/eurheartj/ehy462] [Citation(s) in RCA: 1047] [Impact Index Per Article: 174.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
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Thygesen K, Alpert JS, Jaffe AS, Chaitman BR, Bax JJ, Morrow DA, White HD. Fourth Universal Definition of Myocardial Infarction (2018). Glob Heart 2018; 13:305-338. [PMID: 30154043 DOI: 10.1016/j.gheart.2018.08.004] [Citation(s) in RCA: 166] [Impact Index Per Article: 27.7] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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