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Review
. 2023 Oct 9;12(19):6412.
doi: 10.3390/jcm12196412.

Coronary Artery Disease: A Key Issue in Type 2 Myocardial Infarction: Systematic Review and Recent Findings

Hermann Yao  1   2 , Marianne Zeller  1 , Roland N'Guetta  2 , Yves Cottin  3 , Alain Putot  4
Affiliations
Review

Coronary Artery Disease: A Key Issue in Type 2 Myocardial Infarction: Systematic Review and Recent Findings

Hermann Yao et al. J Clin Med. .

Abstract

Underlying coronary artery disease (CAD) is increasingly considered to be a key issue in the pathophysiology of type 2 myocardial infarction (T2MI). In T2MI, which is attributable to a mismatch between oxygen supply/demand, CAD is common and appears to be more severe than in type 1 myocardial infarction (T1MI). Little is known about the heterogeneous mechanisms that cause supply/demand imbalance and non-coronary triggers leading to myocardial ischemia or about how they are potentially modulated by the presence and severity of CAD. CAD seems to be underrecognized and undertreated in T2MI, even though previous studies have demonstrated both the short and long-term prognostic value of CAD in T2MI. In this literature review, we attempt to address the prevalence and severity of CAD, challenges in the discrimination between T2MI and T1MI in the presence of CAD, and the prognostic value of CAD among patients with T2MI.

Keywords: coronary angiography; coronary artery disease; prognosis; secondary prevention medications; type 2 myocardial infarction.

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Conflict of interest statement

M.Z. Research grants from Amarin Corp and honoraria from Organon for delivering lectures. Y.C. Consultant or speaker for the companies Bayer, BMS/Pfizer, Boehringer Ingelheim, Novartis, Sanofi and Servier. The other authors declare that they have no competing interest.

Figures

Figure 1
Figure 1
Flow chart of the study.
Figure 2
Figure 2
Prevalence of significant coronary artery disease (≥50%) according to type 1 and type 2 myocardial infarction patients undergoing coronary angiography (%) [8,12,14,16,19,20,21,22,24]; T1MI: type 1 myocardial infarction. T2MI: type 2 myocardial infarction. AMIS PLUS: national Registry of Acute Myocardial Infarction in Switzerland; CASABLANCA: Catheter Sampled Blood Archive in Cardiovascular Diseases; DEF-AMI: consequences of the universal 2007 Definition of Acute Myocardial Infarction studied in a Danish consecutive hospital population; SWEDEHEART: Swedish Web-system for Enhancement and Development of Evidence-based care in Heart disease Evaluated According to Recommended Therapies; BACC: Biomarkers in Acute Cardiac Care; DEMAND-MI: Determining the Mechanism of Myocardial Injury and Role of Coronary Disease in Type 2 Myocardial Infarction; * non applicable for T1MI.
Figure 3
Figure 3
Prevalence of history of coronary artery disease according to type 1 and type 2 myocardial infarction (%) [11,15,17,19,20,21,23]; T1MI: type 1 myocardial infarction; T2MI: type 2 myocardial infarction; RICO: ObseRvatoire des Infarctus de la Côte d’Or; BACC: Biomarkers in Acute Cardiac Care; RICO: obseRvatoire des Infarctus de la Côte d’Or; AMIS PLUS: national Registry of Acute Myocardial Infarction in Switzerland; High-STEACS: High-Sensitivity Troponin in the Evaluation of patients with Acute Coronary Syndrome; CASABLANCA: Catheter Sampled Blood Archive in Cardiovascular Diseases.
See this image and copyright information in PMC

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