Aim: To compare in-hospital complications and 30-day and 1-year mortality in patients with type 2 (secondary to ischemic imbalance) vs. type 1 (thromboembolic) myocardial infarction. Methods and results: A total of 20138 patients with acute myocardial infarction (AMI) were registered during 2011 in the Swedish Web-System for Enhancement and Development of Evidence-Based Care in Heart Disease Evaluated According to Recommended Therapies (SWEDEHEART), which includes data on Swedish patients hospitalized with AMI. SWEDEHEART has coverage of 72.1% of all patients hospitalized with a diagnosis of AMI according to the mandatory National Patient Register of discharge diagnoses. In the registry the patients' AMIs were classified into type 1-5. 17488 patients were classified as type 1 (88.5%) and 1403 patients (7.1%) as type 2 AMI. During hospitalization patients with type 2 AMI had significantly higher incidence of bleeding (5.5 vs. 1.0%, p<0.001) and new atrial fibrillation (6.9 vs. 3.9%, p<0.001), lower incidence of cardiogenic shock (1.6 vs. 2.1%, p=0.002), comparable incidence of reinfarction (0.5 vs. 0.9%, p=ns), cardiac arrest (2.0 vs. 3.2%, p=ns) and high grade AV-block (1.4 vs. 1.5%, p=ns). After adjustment for covariates patients with type 2 AMI showed significantly lower 30-day mortality, while there was no significant difference in long-term mortality, see table. View this table: Table 1 Conclusions: After adjustment for differences in demographic variables, co-morbidities and treatments during hospitalization and at discharge, patients with type 2 AMI have an approximately 50% lower 30-day mortality compared to type 1 MI patients, while the long-term mortality is similar.