Cardiologists expand definition of MI

Transatlantic coalition of cardiologists redefine infarction so that severe angina may now be called a heart attack.

By | September 1, 2000

LONDON, 1 September (SPIS MedWire). Even small degrees of myocardial damage should be classified and treated as myocardial infarction (MI), a joint panel of cardiologists representing the US and Europe has decided. The consensus document, published in the Journal of the American College of Cardiology, was prepared by a board of representatives from the American College of Cardiology and the European Society of Cardiology. The panel agreed that, based on new techniques that can enhance the accuracy of diagnosis, any patient previously diagnosed as having severe, stable or unstable angina pectoris who is positive for cardiac troponin should be diagnosed as having had a small acute MI. Participants also agreed that as scientific technology and theory evolve, so too must the way in which patients are diagnosed and their conditions labeled. The introduction of techniques for measuring cardiac troponin served as the cornerstone of the conference's new definition of a heart attack, and pathologic examination, measurement of specific proteins in the blood, electrocardiograph recordings and imaging techniques were found to make this new definition possible. The implications of an expanded definition of a heart attack are wide-ranging. For example, using a new definition of a heart attack in clinical trials may affect patient selection, the generalizability of the trial outcomes, or both. Presidents George Beller, of the ACC, and Lars Rydén, of the ESC, in a joint editorial announcing the release of the conference's consensus document, wrote, "From a worldwide perspective, physicians across the globe should unify through their professional organizations to fight the battle against cardiovascular disease. The recent conference is an excellent example of this cooperative spirit."

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