Type 2 Myocardial Infarction; Patients Characteristics & Clinical Outcomes

Abstract

Abstract Background Type 2 myocardial infarction are emerging concepts suspected of being common in emergency departments (ED). However, their respective frequencies, risk profiles, and short-term prognoses remain to be investigated Objective To assess prevalence and differences in clinical features, current treatment strategies. and outcome in patients with type 2 versus type 1 acute myocardial infarction Methods This Cross sectional prospective study was conducted on 350 Egyptian patients presented in a setting of myocardial infarction allocated to two groups; type I MI and type II MI based on their diagnostic criteria. All patients were recruited from Ain Shams University hospital, Misr University for science and technology hospital during a period of one year [from February 2022 to February 2023 then patients were followed regarding prevalence, patient characteristics, in hospital management and clinical outcomes especially mortality (in-hospital, 30 days and 6. months), MACE and heart failure hospitalization] Results The mean age of the studied cases was 56.35 ± 9.52 years, males represented 56.3% of cases, there were 54.9% of the studied cases smokers, 23.1% had a history of IHD, 20% with history of CHF, and 38.3% had a positive family history of heart disease. DM was present in 45.4% of cases while HTN was present in 75.1% of cases. Regarding the type of MI, most of the studied patients had type I (74.9%) and 25.1% had type II MI. There was a significant higher length of stay in type II (median 12 days compared to 5 days) in type I and occurrence of death (13.6% Vs 5.7%) in type I and stroke at 6 months also was significantly higher in type II (3.4% Vs 0.4%) in type I but at 1 month MACE didn’t differ significantly Conclusions: Type I myocardial infarction is more prevalent than type II, however type II MI is associated with higher mortality rates and longer duration of hospital admissions. The clinical presentation differs between both types where type I MI patients present with chest pain, type II patients present mainly with dyspnea, syncope and dynamic instability. Also, the management plan. differs significantly showing that cardiac intervention is mainly directed for type I MI patients