Universal Definition of MI

Type 1

Spontaneous MI related to ischaemia due to a primary coronary event such as plaque erosion and/or rupture, fissuring, or dissection.

Type 2

MI secondary to ischaemia due to either increased oxygen demand or decreased supply, e.g. coronary artery spasm, coronary embolism, anaemia, arrhythmias, hypertension, or hypotension.

Type 3

Sudden unexpected cardiac death, including cardiac arrest, often with symptoms suggestive of myocardial ischaemia, accompanied by presumably new ST elevation, or new LBBB, or evidence of fresh thrombus in a coronary artery by angiography and/or at autopsy, but death occurring before blood samples could be obtained, or at a time before the appearance of cardiac biomarkers in the blood.

Type 4A

MI associated with PCI. Increases of biomarkers above the 99th percentile URL indicate of peri-procedural myocardial necrosis (normal baseline troponin). Increases of biomarkers greater than 3 x 99th percentile URL define defining PCI-related MI.

Type 4B

MI associated with stent thrombosis as documented by angiography or at autopsy.

Type 5

MI associated with CABG. Increases of biomarkers above the 99th percentile URL indicate of peri-procedural myocardial necrosis (normal baseline troponin). Increases of biomarkers greater than 5 x 99th percentile URL plus either new pathological Q waves or new LBBB, or angiographically documented new graft or native coronary artery occlusion, or imaging evidence of new loss of viable myocardium have been designated as defining CABG-related myocardial infarction.

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