The appropriateness of coronary investigation in myocardial injury and type 2 myocardial infarction (ACT-2): A randomized trial design

dc.contributor.author Lambrakis, Kristina
dc.contributor.author French, John K
dc.contributor.author Scott, Ian A
dc.contributor.author Briffa, Tom
dc.contributor.author Brieger, David
dc.contributor.author Farkouh, Michael E
dc.contributor.author White, Harvey D
dc.contributor.author Chuang, Anthony
dc.contributor.author Tiver, Kathryn
dc.contributor.author Quinn, Stephen
dc.contributor.author Kaambwa, Billingsley
dc.contributor.author Horsfall, Matthew
dc.contributor.author Morton, Erin
dc.contributor.author Chew, Derek Peng
dc.date.accessioned 2018-12-07T02:00:58Z
dc.date.available 2018-12-07T02:00:58Z
dc.date.issued 2018-10-25
dc.description This manuscript version is made available under the CC-BY-NC-ND 4.0 license: http://creativecommons.org/licenses/by-nc-nd/4.0/ which permits use, distribution and reproduction in any medium, provided the original work is properly cited. This author accepted manuscript is made available following 12 month embargo from date of publication (October 2018) in accordance with the publisher’s archiving policy en_US
dc.description.abstract Background: Elevated troponin level findings among patients presenting with suspected acute coronary syndrome (ACS) or another intercurrent illness undeniably identifies patients at increased risk of mortality. Whilst enhancing our capacity to discriminate risk, the use of high-sensitivity troponin assays frequently identifies patients with myocardial injury (i.e. troponin rise without acute signs of myocardial ischemia) or type 2 myocardial infarction (T2MI; oxygen supply-demand imbalance). This leads to the clinically challenging task of distinguishing type 1 myocardial infarction (T1MI; coronary plaque rupture) from myocardial injury and T2MI in the context of concurrent acute illness. Diagnostic discernment in this context is crucial because MI classification has implications for further investigation and care. Early invasive management is of well-established benefit among patients with T1MI. However, the appropriateness of this investigation in the heterogeneous context of T2MI, where there is high competing mortality risk, remains unknown. Although coronary angiography in T2MI is advocated by some, there is insufficient evidence in existing literature to support this opinion as highlighted by current national guidelines. en_US
dc.description.sponsorship Support for this study was granted from National Health and Medical Research Council of Australia (APP1146512). en_US
dc.identifier.citation Lambrakis, K., French, J. K., Scott, I. A., Briffa, T., Brieger, D., Farkouh, M. E., … Chew, D. P. (2019). The appropriateness of coronary investigation in myocardial injury and type 2 myocardial infarction (ACT-2): A randomized trial design. American Heart Journal, 208, 11–20. en_US
dc.identifier.doi https://doi.org/10.1016/j.ahj.2018.09.016 en_US
dc.identifier.issn 1097-6744
dc.identifier.uri http://hdl.handle.net/2328/38657
dc.language.iso en en_US
dc.publisher Elsevier en_US
dc.relation.grantnumber NHMRC/APP1146512 en_US
dc.rights © 2018 Elsevier Inc. All rights reserved. This manuscript version is made available under the CC-BY-NC-ND 4.0 license: http://creativecommons.org/licenses/by-nc-nd/4.0/ en_US
dc.rights.holder © 2018 Elsevier Inc. All rights reserved. en_US
dc.rights.license CC-BY-NC-ND
dc.title The appropriateness of coronary investigation in myocardial injury and type 2 myocardial infarction (ACT-2): A randomized trial design en_US
dc.type Article en_US
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