Type 2 myocardial infarction: the chimaera of cardiology?

Area of Science:

• Cardiology
• Clinical Medicine
• Biomedical Science

Background:

• Type 2 myocardial infarction (T2MI) was introduced to define myocardial damage with elevated troponin but without typical acute myocardial infarction criteria.
• The definition of T2MI has remained vague, often characterized by exclusion rather than positive criteria.
• Clinical studies report inconsistent incidence and associated conditions for T2MI.

Purpose of the Study:

• To critically evaluate the current definition and clinical utility of type 2 myocardial infarction.
• To propose an alternative concept for myocardial injury secondary to other conditions.

Main Methods:

• Review of the existing literature and definitions of type 2 myocardial infarction.
• Analysis of the clinical implications and diagnostic challenges associated with T2MI.
• Conceptual re-evaluation of myocardial injury in non-coronary settings.

Main Results:

• The definition of T2MI is inconsistent and lacks clear diagnostic criteria.
• Disparate incidence rates and varying associated conditions are reported across studies.
• There is a lack of evidence-based treatment guidelines for T2MI.

Conclusions:

• The term type 2 myocardial infarction is confusing and not evidence-based.
• The authors recommend ceasing the use of the term T2MI.
• The concept of secondary myocardial injury is proposed as a more accurate and pathophysiology-based alternative.