Abstract 8904: Predictors of Type 1 and Type 2 Myocardial Infarction

Abstract

Background: Our understanding of the risk factors for myocardial infarction (MI) is limited to type 1 events caused by atherosclerotic plaque rupture and thrombosis. It is unclear whether similar risk factors are related to future type 2 MI events. Hypothesis: Cardiovascular disease risk factors are important in predicting type 2 MI Method: We conducted a secondary analysis of a multi-centre randomised trial population of 48,282 consecutive patients attending hospital with suspected acute coronary syndrome. Cox regression was used to identify predictors of future type 1 and type 2 MI during a one-year follow-up period. Results: During one-year of follow up 1,331 patients had a subsequent MI, with 924 and 407 adjudicated as type 1 and type 2 myocardial infarction, respectively. Risk factors for type 1 and type 2 MI were similar, with age, hyperlipidaemia, diabetes, increasing creatinine concentration, and known coronary disease important predictors for both (P<0.05 for all). Whilst male sex is an established risk factor for type 1 MI, sex did not predict type 2 myocardial infarction (adjusted HR 0.82, 95% CI 0.66 to 1.01). The strongest predictor of type 2 MI was a prior history of type 2 events (aHR 6.18, 95% CI 4.70 to 8.12, Figure). Conclusions: Cardiovascular risk factors associated with type 1 MI are also important predictors of type 2 MI, suggesting common mechanisms including coronary disease are important. Treatment of these risk factors may reduce future susceptibility to both type 1 and type 2 MI.