Clinical cases of various types of myocardialinfarction from the position of choosing the optimalapproaches to secondary prevention

Authors: Pecherina Т.B.1 2, Kashtalap V.V.1 3

Company: 1Research Institute for Complex Issues of Cardiovascular Diseases, Sosnovyy bul’var, 6, Kemerovo, 650002, Russian Federation;
2Kemerovo Regional Clinical Cardiology Dispensary named after academician L.S. Barbarash, Sosnovyy bul’var, 6, Kemerovo, 650002, Russian Federation;
3Kemerovo State Medical University, ulitsa Voroshilova, 22a, Kemerovo, 650056, Russian Federation

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Type:  Case reports


DOI: https://doi.org/10.24022/1997-3187-2019-13-4-363-374

For citation: Pecherina Т.B., Kashtalap V.V. Clinical cases of various types of myocardial infarction from the position of choosing the optimal approaches to secondary prevention. Creative Cardiology. 2019; 13 (4): 363–74 (in Russ.). DOI: 10.24022/ 1997-3187-2019-13-4-363-374

Received / Accepted:  29.11.2019/16.12.2019

Keywords: myocardialinfarction types 1 and 2 atrial fibrillation secondary prevention

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Abstract

The article presents clinical cases illustrating the importance of the division of patients depending on the type of myocardial infarction into the types 1 and 2 in accordance with the new 4th universal definition of myocardial infarction. Two examples illustrate the difficulties in choosing optimal therapy in patients with different types of myocardial infarction and co-morbidities, including atrial fibrillation. In the first case, the patient has a classic type 1 myocardial infarction, with the need for aggressive antithrombotic therapy for 12 months and long-term baseline drugs for coronary heart disease. The patient from the second clinical case has a type 2 myocardial infarction with the need only for monotherapy with oral anticoagulants to improve the prognosis. However, in clinical practice, it is extremely difficult to distinguish patients with different types of myocardial infarction, and therefore therapy in such patients is suboptimal. Based on the aforesaid, it is proposed to actively use in wide clinical practice the possibilities of a new international conciliation document “Fourth universal definition of myocardial infarction”.

References

  1. Saaby L., Poulsen T.S., Diederichsen A.C.P. et al. Mortality rate in type 2 myocardial infarction: observations from an unselected hospital cohort. Am. J. Med. 2014; 127: 295–302.
  2. Sandoval Y., Smith S.W., Apple F.S. Type 2 myocardial infarction: the next frontier. Am. J. Med. 2014; 127: e19.
  3. Bonaca M.P., Wiviott S.D., Braunwald E. et al. American College of Cardiology/American Heart Association/European Society of Cardiology/ World Heart Federation universal definition of myocardial infarction classification system and the risk of cardiovascular death: observations from the TRITON-TIMI 38 trial (Trial to Assess Improvement in Therapeutic Outcomes by Optimizing Platelet Inhibition WithPra-sugrel-Thrombolysis in Myocardial Infarction 38). Circulation. 2012; 125: 577–83.
  4. El-Haddad H., Robinson E., Swett K. et al. Prognostic implications of type 2 myocardial infarctions. World J. Cardiovasc. Dis. 2012; 2: 237–41.
  5. Barbarash O.L., Kashtalap V.V. Fourth universal definition of myocardial infarction. Focus on the type 2 myocardial infarction. Fundamental and Clinical Medicine. 2018; 3 (4): 73–82. DOI: 10.23946/2500-0764-2018-3-4-73-82 (in Russ.).
  6. Szummer K., Wallentin L., Lindhagen L., Alfredsson J.J., Erlinge D., Held C. et al. Relations between implementation of new treatments and improved outcomes in patients with non-ST-elevation myocardial infarction during the last 20 years: experiences from SWEDEHEART registry 1995 to 2014. Eur. Heart J. 2018; 39: 3766–76. DOI: 10.1093/eurheartj/ehy554
  7. Szummer K., Wallentin L., Lindhagen L., Alfredsson J., Erlinge D., Held C. et al. Improved outcomes in patients with ST-elevation myocardial infarction during the last 20 years are related to implementation of evidence-based treatments: experiences from the SWEDEHEART registry 1995–2014. Eur. Heart J. 2017; 38: 3056–65.
  8. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Russian Journal of Cardiology. 2017; 7 (147): 7–86. DOI: 10.15829/1560–4071-2017-7-7-86 (in Russ.)
  9. Wang T.Y., Robinson L.A., Ou F.-S. et al. Discharge antithrombotic strategies among patients with acute coronary syndrome previously on warfarin anticoagulation: Physician practice in the CRUSADE registry. Am. Heart J. 2008; 155: 361–8. DOI: 10.1016/j.ahj.2007.09.003
  10. Thygesen K., Alpert J.S., Jaffe A.S. Fourth universal definition of myocardial infarction (2018). Eur. Heart J. 2019; 40 (3): 237–69. DOI: 10.1093/eurheartj/ehy462
  11. O’Sullivan C.J., Sprenger M., Tueller D. et al. Coronary thromboembolic acute myocardial infarction due to paroxysmal atrial fibrillation occurring after non-cardiac surgery. BMJ Case Rep. 2015. PII: bcr2014208329. DOI: 10.1136/bcr-2014-208329
  12. Violi F., Soliman E.Z., Pignatelli P. et al. Atrial fibrillation and myocardial infarction: a systematic review and appraisal of pathophysiologic mechanisms. J. Am. Heart Assoc. 2016; 5 (5). DOI: 10.1161/JAHA.116.003347
  13. Stamboul K., Fauchier L., Gudjoncik A., Buffet P., Garnier F. et al. New insights into symptomatic or silent atrial fibrillation complicating acute myocardial infarction. Arch. Cardiovasc. Dis. 2015; 108: 598–605. DOI: 10.1016/j.acvd.2015.06.009
  14. Soliman E.Z., Safford M.M., Munter P., Khodneva Y., Dawood F.Z. et al. Atrial fibrillation and the risk of myocardial infarction. JAMA Intern. Med. 2014; 174 (1): 107–14. DOI: 10.1001/jamainternmed.2013.11912
  15. Sandoval Y., Smith S.W., Yhordsen S.E., Apple F.S. Supply/demand type 2 myocardial infarction: should we be paying more attention? J. Am. Coll. Cardiol. 2014; 63: 2079–87. DOI: 10.1016/j.jacc.2014.02.541
  16. Pecherina T.B., Zlydneva V.O., Kashtalap V.V., Barbarash O.L. Patient with myocardial infarction, atrial fibrillation and high risk for hemorrhage: reasonable choice of anticoagulant for effective prevention of ischemic events. Complex Issues of Cardiovascular Diseases. 2018; 7 (4S): 135–45. DOI: 10.17802/2306-1278-2018-7-4S-135-145 (in Russ.)

About Authors

  • Tamara B. Pecherina, Cand. Med. Sc., Senior Researcher, ORCID
  • Vasiliy V. Kashtalap, Dr. Med. Sc., Associate Professor, Head of Laboratory, ORCID

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, Director of Bakoulev National Medical Research Center for Cardiovascular Surgery