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10.1161/CIRCULATIONAHA.115.016502

http://scihub22266oqcxt.onion/10.1161/CIRCULATIONAHA.115.016502
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suck abstract from ncbi


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pmid26350057
      Circulation 2015 ; 132 (18 ): 1710-8
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  • The Variation in Recovery: Role of Gender on Outcomes of Young AMI Patients (VIRGO) Classification System: A Taxonomy for Young Women With Acute Myocardial Infarction #MMPMID26350057
  • Spatz ES ; Curry LA ; Masoudi FA ; Zhou S ; Strait KM ; Gross CP ; Curtis JP ; Lansky AJ ; Soares Barreto-Filho JA ; Lampropulos JF ; Bueno H ; Chaudhry SI ; D'Onofrio G ; Safdar B ; Dreyer RP ; Murugiah K ; Spertus JA ; Krumholz HM
  • Circulation 2015[Nov]; 132 (18 ): 1710-8 PMID26350057 show ga
  • BACKGROUND: Current classification schemes for acute myocardial infarction (AMI) may not accommodate the breadth of clinical phenotypes in young women. METHODS AND RESULTS: We developed a novel taxonomy among young adults (?55 years) with AMI enrolled in the Variation in Recovery: Role of Gender on Outcomes of Young AMI Patients (VIRGO) study. We first classified a subset of patients (n=600) according to the Third Universal Definition of MI using a structured abstraction tool. There was heterogeneity within type 2 AMI, and 54 patients (9%; including 51 of 412 women) were unclassified. Using an inductive approach, we iteratively grouped patients with shared clinical characteristics, with the aims of developing a more inclusive taxonomy that could distinguish unique clinical phenotypes. The final VIRGO taxonomy classified 2802 study participants as follows: class 1, plaque-mediated culprit lesion (82.5% of women; 94.9% of men); class 2, obstructive coronary artery disease with supply-demand mismatch (2a: 1.4% women; 0.9% men) and without supply-demand mismatch (2b: 2.4% women; 1.1% men); class 3, nonobstructive coronary artery disease with supply-demand mismatch (3a: 4.3% women; 0.8% men) and without supply-demand mismatch (3b: 7.0% women; 1.9% men); class 4, other identifiable mechanism (spontaneous dissection, vasospasm, embolism; 1.5% women, 0.2% men); and class 5, undetermined classification (0.8% women, 0.2% men). CONCLUSIONS: Approximately 1 in 8 young women with AMI is unclassified by the Universal Definition of MI. We propose a more inclusive taxonomy that could serve as a framework for understanding biological disease mechanisms, therapeutic efficacy, and prognosis in this population.
  • |*Sex Factors [MESH]
  • |Adolescent [MESH]
  • |Adult [MESH]
  • |Age of Onset [MESH]
  • |Algorithms [MESH]
  • |Aortic Dissection/complications [MESH]
  • |Classification/methods [MESH]
  • |Coronary Disease/classification/complications/pathology [MESH]
  • |Diagnostic Techniques, Cardiovascular [MESH]
  • |Female [MESH]
  • |Humans [MESH]
  • |Male [MESH]
  • |Medical Records [MESH]
  • |Middle Aged [MESH]
  • |Myocardial Infarction/*classification/diagnosis/etiology [MESH]
  • |Myocardium/metabolism [MESH]
  • |Oxygen Consumption [MESH]
  • |Phenotype [MESH]
  • |Plaque, Atherosclerotic/complications [MESH]
  • |Prospective Studies [MESH]
  • |Reproducibility of Results [MESH]
  • |Risk Factors [MESH]
  • |Treatment Outcome [MESH]


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