{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T16:37:17Z","timestamp":1793723837372,"version":"4.6.1"},"reference-count":34,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2018,3,20]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Type 2 myocardial infarction and myocardial injury are common in clinical practice, but long-term consequences are uncertain. We aimed to define long-term outcomes and explore risk stratification in patients with type 2 myocardial infarction and myocardial injury.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We identified consecutive patients (n=2122) with elevated cardiac troponin I concentrations (\u22650.05 \u00b5g\/L) at a tertiary cardiac center. All diagnoses were adjudicated as per the universal definition of myocardial infarction. The primary outcome was all-cause death. Secondary outcomes included major adverse cardiovascular events (eg, nonfatal myocardial infarction or cardiovascular death) and noncardiovascular death. To explore competing risks, cause-specific hazard ratios were obtained using Cox regression models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The adjudicated index diagnosis was type 1 or 2 myocardial infarction or myocardial injury in 1171 (55.2%), 429 (20.2%), and 522 (24.6%) patients, respectively. At 5 years, all-cause death rates were higher in those with type 2 myocardial infarction (62.5%) or myocardial injury (72.4%) compared with type 1 myocardial infarction (36.7%). The majority of excess deaths in those with type 2 myocardial infarction or myocardial injury were because of noncardiovascular causes (hazard ratio, 2.32; 95% confidence interval, 1.92\u20132.81 versus type 1 myocardial infarction). Despite this finding, the observed crude major adverse cardiovascular event rates were similar between groups (30.6% versus 32.6%), with differences apparent after adjustment for covariates (hazard ratio, 0.82; 95% confidence interval, 0.69\u20130.96). Coronary heart disease was an independent predictor of major adverse cardiovascular events in those with type 2 myocardial infarction or myocardial injury (hazard ratio, 1.71; 95% confidence interval, 1.31\u20132.24).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Despite an excess in noncardiovascular death, patients with type 2 myocardial infarction or myocardial injury have a similar crude rate of major adverse cardiovascular events as those with type 1 myocardial infarction. Identifying underlying coronary heart disease in this vulnerable population may help target therapies that could modify future risk.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circulationaha.117.031806","type":"journal-article","created":{"date-parts":[[2017,11,17]],"date-time":"2017-11-17T05:30:12Z","timestamp":1510896612000},"page":"1236-1245","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":321,"title":["Long-Term Outcomes in Patients With Type 2 Myocardial Infarction and Myocardial Injury"],"prefix":"10.1161","volume":"137","author":[{"given":"Andrew R.","family":"Chapman","sequence":"first","affiliation":[{"name":"British Heart Foundation, University Centre for Cardiovascular Science, University of Edinburgh, United Kingdom (A.R.C., A.S.V.S., K.K.L., A.A., O.F., P.A., F.E.S., D.E.N., N.L.M.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anoop S.V.","family":"Shah","sequence":"additional","affiliation":[{"name":"British Heart Foundation, University Centre for Cardiovascular Science, University of Edinburgh, United Kingdom (A.R.C., A.S.V.S., K.K.L., A.A., O.F., P.A., F.E.S., D.E.N., N.L.M.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kuan Ken","family":"Lee","sequence":"additional","affiliation":[{"name":"British Heart Foundation, University Centre for Cardiovascular Science, University of Edinburgh, United Kingdom (A.R.C., A.S.V.S., K.K.L., A.A., O.F., P.A., F.E.S., D.E.N., N.L.M.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atul","family":"Anand","sequence":"additional","affiliation":[{"name":"British Heart Foundation, University Centre for Cardiovascular Science, University of Edinburgh, United Kingdom (A.R.C., A.S.V.S., K.K.L., A.A., O.F., P.A., F.E.S., D.E.N., 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E.","family":"Strachan","sequence":"additional","affiliation":[{"name":"British Heart Foundation, University Centre for Cardiovascular Science, University of Edinburgh, United Kingdom (A.R.C., A.S.V.S., K.K.L., A.A., O.F., P.A., F.E.S., D.E.N., N.L.M.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David E.","family":"Newby","sequence":"additional","affiliation":[{"name":"British Heart Foundation, University Centre for Cardiovascular Science, University of Edinburgh, United Kingdom (A.R.C., A.S.V.S., K.K.L., A.A., O.F., P.A., F.E.S., D.E.N., N.L.M.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas L.","family":"Mills","sequence":"additional","affiliation":[{"name":"British Heart Foundation, University Centre for Cardiovascular Science, University of Edinburgh, United Kingdom (A.R.C., A.S.V.S., K.K.L., A.A., O.F., P.A., F.E.S., D.E.N., 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