Experts redefine heart attack to improve care for women, get clinicians on the same page

Heart specialists from all over the world have worked together to update the universal definition of myocardial infarction (MI). This includes a new classification system that separates events into three categories: primary MI, secondary MI and procedure-related MI. 

This update represents a collaboration between representatives from the American College of Cardiology (ACC), European Society of Cardiology, American Heart Association and World Heart Federation. It was published in JACC, ACC’s flagship journal.[1]

The task force behind this new document worked to emphasize the differences between treating men and women, include more details for diagnosing silent or unrecognized MIs, and provide guidance for the diagnosis of MI in low-resource settings. In addition, the new definition includes recommended ICD-11 codes that could help clinicians use the new classification system. 

The group also wanted to improve consistency from one care team to the next when diagnosing and managing MIs. This should help make it easier to adopt new findings into everyday practice, they wrote, and help specialists learn from between-country comparisons. 

“The definition incorporates sex-specific cardiac troponin thresholds to avoid systematic bias and under diagnosis in female patients,” L. Kristen Newby, MD, a cardiologist with Duke Health and co-chair of the new document, said in a statement. “The use of imaging is encouraged to define the etiology of MI, and this will support more personalized care, recognizing that treatment differs depending on the underlying cause and setting in which it occurs.”