Management and outcome trends in type 2 myocardial infarction: an investigation from the SWEDEHEART registry
Abstract Despite poor prognosis, patients with type 2 myocardial infarction (MI) tend to be underdiagnosed and undertreated compared to those with type 1 MI. Whether this discrepancy has improved over time is uncertain. We conducted a registry-based cohort study investigating type 2 MI patients mana...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2023-05-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-023-34312-7 |
| _version_ | 1827952771434807296 |
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| author | K. M. Eggers T. Baron A. R. Chapman A. Gard B. Lindahl |
| author_facet | K. M. Eggers T. Baron A. R. Chapman A. Gard B. Lindahl |
| author_sort | K. M. Eggers |
| collection | DOAJ |
| description | Abstract Despite poor prognosis, patients with type 2 myocardial infarction (MI) tend to be underdiagnosed and undertreated compared to those with type 1 MI. Whether this discrepancy has improved over time is uncertain. We conducted a registry-based cohort study investigating type 2 MI patients managed at Swedish coronary care units (n = 14,833) during 2010–2022. Multivariable-adjusted changes (first three vs last three calendar years of the observation period) were assessed regarding diagnostic examinations (echocardiography, coronary assessment), provision of cardioprotective medications (betablockers, renin–angiotensin–aldosterone-system inhibitors, statins) and 1-year all-cause mortality. Compared to type 1 MI patients (n = 184,329), those with type 2 MI less often had diagnostic examinations and cardioprotective medications. Increases in the use of echocardiography (OR 1.08 [95% confidence interval 1.06–1.09]) and coronary assessment (OR 1.06 [95% confidence interval 1.04–1.08]) were smaller compared to type 1 MI (pinteraction < 0.001). The provision of medications did not increase in type 2 MI. All-cause mortality rate in type 2 MI was 25.4% without temporal change (OR 1.03 [95% confidence interval 0.98–1.07]). Taken together, the provision of medications and all-cause mortality did ot improve in type 2 MI despite modest increases in diagnostic procedures. This emphasizes the need of defining optimal care pathways in these patients. |
| first_indexed | 2024-04-09T14:02:51Z |
| format | Article |
| id | doaj.art-017d8ff11cc744e3b4e1318a9cc71ed2 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-04-09T14:02:51Z |
| publishDate | 2023-05-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-017d8ff11cc744e3b4e1318a9cc71ed22023-05-07T11:10:31ZengNature PortfolioScientific Reports2045-23222023-05-011311710.1038/s41598-023-34312-7Management and outcome trends in type 2 myocardial infarction: an investigation from the SWEDEHEART registryK. M. Eggers0T. Baron1A. R. Chapman2A. Gard3B. Lindahl4Department of Medical Sciences, CardiologyUppsala UniversityDepartment of Medical Sciences, CardiologyUppsala UniversityBHF Centre for Cardiovascular Science, University of EdinburghDepartment of Medical Sciences, CardiologyUppsala UniversityDepartment of Medical Sciences, CardiologyUppsala UniversityAbstract Despite poor prognosis, patients with type 2 myocardial infarction (MI) tend to be underdiagnosed and undertreated compared to those with type 1 MI. Whether this discrepancy has improved over time is uncertain. We conducted a registry-based cohort study investigating type 2 MI patients managed at Swedish coronary care units (n = 14,833) during 2010–2022. Multivariable-adjusted changes (first three vs last three calendar years of the observation period) were assessed regarding diagnostic examinations (echocardiography, coronary assessment), provision of cardioprotective medications (betablockers, renin–angiotensin–aldosterone-system inhibitors, statins) and 1-year all-cause mortality. Compared to type 1 MI patients (n = 184,329), those with type 2 MI less often had diagnostic examinations and cardioprotective medications. Increases in the use of echocardiography (OR 1.08 [95% confidence interval 1.06–1.09]) and coronary assessment (OR 1.06 [95% confidence interval 1.04–1.08]) were smaller compared to type 1 MI (pinteraction < 0.001). The provision of medications did not increase in type 2 MI. All-cause mortality rate in type 2 MI was 25.4% without temporal change (OR 1.03 [95% confidence interval 0.98–1.07]). Taken together, the provision of medications and all-cause mortality did ot improve in type 2 MI despite modest increases in diagnostic procedures. This emphasizes the need of defining optimal care pathways in these patients.https://doi.org/10.1038/s41598-023-34312-7 |
| spellingShingle | K. M. Eggers T. Baron A. R. Chapman A. Gard B. Lindahl Management and outcome trends in type 2 myocardial infarction: an investigation from the SWEDEHEART registry Scientific Reports |
| title | Management and outcome trends in type 2 myocardial infarction: an investigation from the SWEDEHEART registry |
| title_full | Management and outcome trends in type 2 myocardial infarction: an investigation from the SWEDEHEART registry |
| title_fullStr | Management and outcome trends in type 2 myocardial infarction: an investigation from the SWEDEHEART registry |
| title_full_unstemmed | Management and outcome trends in type 2 myocardial infarction: an investigation from the SWEDEHEART registry |
| title_short | Management and outcome trends in type 2 myocardial infarction: an investigation from the SWEDEHEART registry |
| title_sort | management and outcome trends in type 2 myocardial infarction an investigation from the swedeheart registry |
| url | https://doi.org/10.1038/s41598-023-34312-7 |
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