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Updated: Oct 3, 2026

A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia
06:01

A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia

Published on: August 18, 2015

Risk factors for 'microsize' vs. usual myocardial infarctions in the REasons for Geographic and Racial Differences in

Zaid I Almarzooq1, Lisandro D Colantonio2, Peter M Okin3

  • 1Division of Cardiovascular Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, USA.

European Heart Journal. Quality of Care & Clinical Outcomes
|March 8, 2019
PubMed
Abstract

Insights

Microsize myocardial infarction (MI) shares risk factors with usual MI, including age, diabetes, and urinary albumin. Clinicians should manage reversible risk factors and initiate secondary prevention for microsize MI.

Area of Science:

  • Cardiology
  • Epidemiology
  • Biomarkers

Background:

  • Myocardial infarction (MI) with low peak troponin levels, termed 'microsize MI', is a common phenomenon.
  • Microsize MI is associated with an increased risk of all-cause mortality.
  • Understanding the distinct risk factors for microsize MI is crucial for effective management.

Purpose of the Study:

  • To compare the risk factors associated with microsize MI versus usual MI.
  • To identify specific risk factor profiles for each type of MI.

Main Methods:

  • Analysis of 24,470 participants from the REGARDS cohort, excluding those with pre-existing coronary heart disease.
  • Expert adjudication of heart-related hospitalizations to classify MIs as microsize (peak troponin <0.5 ng/mL) or usual (peak troponin ≥0.5 ng/mL).
  • Competing risk analyses were used to assess associations between baseline risk factors and incident microsize vs. usual MI.

Main Results:

  • A total of 891 MIs occurred between 2003-2013, with 279 classified as microsize MI and 612 as usual MI.
  • Common risk factors for both microsize and usual MI included age, gender, diabetes, and elevated urinary albumin to creatinine ratio.
  • Risk factors exclusive to usual MI were residing in the Stroke Belt/Buckle regions and current smoking. Black race was associated with a lower risk of usual MI.

Conclusions:

  • The shared risk profiles suggest a potential common etiology between microsize and usual MI.
  • Clinicians should address reversible risk factors and implement secondary prevention strategies for microsize MI.
  • Further research is needed to elucidate the clinical outcomes and optimal management of microsize MI.
Keywords:
Acute coronary syndromeMicrosize MIMortalityRisk factorsTroponin

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