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2015 ; 132
(18
): 1710-8
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
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.