New horizons in Type 2 myocardial infarction: pathogenesis, assessment and management of an emerging geriatric disease
| Autor: | Alain Putot, Sophie Putot, Frédéric Chagué, Yves Cottin, Marianne Zeller, Patrick Manckoundia |
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| Rok vydání: | 2022 |
| Předmět: | |
| Zdroj: | Age and Ageing. 51 |
| ISSN: | 1468-2834 0002-0729 |
| DOI: | 10.1093/ageing/afac085 |
| Popis: | Type 2 myocardial infarction (MI) is characterised by a functional imbalance between myocardial oxygen supply and demand in the absence of a thrombotic process, leading to myocardial necrosis. This type of MI was relatively unknown among clinicians until the third universal definition of MI was published in 2017, differentiating Type 2 from Type 1 MI, which follows an acute atherothrombotic event. The pathogenesis, diagnostic and therapeutic aspects of Type 2 MI are described in the present review. Type 2 MI is a condition that is strongly linked to age because of vascular ageing concerning both epicardic vessels and microcirculation, age-related atherosclerosis and stress maladaptation. This condition predominantly affects multimorbid individuals with a history of cardiovascular disease. However, the conditions that lead to the functional imbalance between oxygen supply and demand are frequently extra-cardiac (e.g. pneumonia or anaemia). The great heterogeneity of the underlying etiological factors requires a comprehensive approach that is tailored to each case. In the absence of evidence for the benefit of invasive reperfusion strategies, the treatment of Type 2 MI remains to date essentially based on the restoration of the balance between oxygen supply and demand. For older co-morbid patients with Type 2 MI, geriatricians and cardiologists need to work together to optimise etiological investigations, treatment and prevention of predisposing conditions and precipitating factors. |
| Databáze: | OpenAIRE |
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