World Health Organization definition of myocardial infarction: 2008-09 revision
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Open Access
- 4 October 2010
- journal article
- research article
- Published by Oxford University Press (OUP) in International Journal of Epidemiology
- Vol. 40 (1), 139-146
- https://doi.org/10.1093/ije/dyq165
Abstract
Background WHO has played a leading role in the formulation and promulgation of standard criteria for the diagnosis of coronary heart disease and myocardial infarction since early 1970s. Methods The revised definition takes into consideration the following: well-resourced settings can use the ESC/ACC/AHA/WHF definition, which has new biomarkers as a compulsory feature; in resource-constrained settings, a typical biomarker pattern cannot be made a compulsory feature as the necessary assays may not be available; the definition must also have provision for diagnosing non-fatal events with incomplete information on cardiac biomarkers and the ECG; to facilitate epidemiologic monitoring definition must recognize fatal events with incomplete or no information on cardiac biomarkers and/or ECG and/or autopsy and/or coronary angiography. Results Category A definition is the same as ESC/ACC/AHA/WHF definition of MI, and can be applied to settings with no resource constraints. Category B definition of MI is to be applied whenever there is incomplete information on cardiac bio-markers together with symptoms of ischaemia and the development of unequivocal pathological Q waves. Category C definition (probable MI) is to be applied when individuals with MI may not satisfy Category A or B definitions because of delayed access to medical services and/or unavailability of electrocardiography and/or laboratory assay of cardiac biomarkers. In these situations, the term probable MI should be used when there is either ECG changes suggestive of MI or incomplete information on cardiac biomarkers in a person with symptoms of ischaemia with no evidence of a non-coronary reason. Conclusions This article presents the 2008–09 revision of the World Health Organization (WHO) definition of myocardial infarction (MI) developed at a WHO expert consultation.Keywords
This publication has 10 references indexed in Scilit:
- Universal definition of myocardial infarction: Kristian Thygesen, Joseph S. Alpert and Harvey D. White on behalf of the Joint ESC/ACCF/AHA/WHF Task Force for the Redefinition of Myocardial InfarctionEuropean Heart Journal, 2007
- The effect of correcting for troponins on trends in coronary heart disease events in Finland during 1993-2002: the FINAMI studyEuropean Heart Journal, 2006
- Redefinition of Myocardial InfarctionCirculation, 2006
- Biomarkers in Acute Cardiac Disease: The Present and the FutureJournal of the American College of Cardiology, 2006
- Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control studyThe Lancet, 2004
- Clinical implications of the new definition of myocardial infarctionHeart, 2004
- Case Definitions for Acute Coronary Heart Disease in Epidemiology and Clinical Research StudiesCirculation, 2003
- Myocardial infarction redefined—A consensus document of The Joint European Society of Cardiology/American College of Cardiology Committee for the Redefinition of Myocardial InfarctionEuropean Heart Journal, 2000
- Myocardial infarction and coronary deaths in the World Health Organization MONICA Project. Registration procedures, event rates, and case-fatality rates in 38 populations from 21 countries in four continents.Circulation, 1994
- Nomenclature and criteria for diagnosis of ischemic heart disease. Report of the Joint International Society and Federation of Cardiology/World Health Organization task force on standardization of clinical nomenclature.Circulation, 1979