2008年ESC心肌梗死分型

2008年ESC心肌梗死分型：
1.自发性心肌梗死：主要因自发性冠脉事件所引发。
2.继发性心肌梗死：主要由于供氧供血失调所致的心肌梗死。
3.伴有心肌缺血或冠脉内血栓的心源性猝死型心肌梗死。
4.PCI相关的心肌梗死；支架内血栓相关的心肌梗死。
5.CABG相关的心肌梗死。
确诊PCI相关的心肌标志物升高是以正常值的（99%的百分位值）3倍为标准，而确诊CABG相关的心肌梗死则以正常值的5倍为标准。
这是最新的，望斑竹加分，不尽感谢！！！
请问此分型的出处
这个分型应该是UniversalDefinitionofMyocardialInfarction的部分内容，有想学习的战友，我上传上去。太大了，传不上去。部分内容：
Table1Clinicalclassificationofdifferenttypesofmyocardial
infarction
Type1
Spontaneousmyocardialinfarctionrelatedtoischaemiadueto
aprimarycoronaryeventsuchasplaqueerosionand/or
rupture,fissuring,ordissection
Type2
Myocardialinfarctionsecondarytoischaemiaduetoeither
increasedoxygendemandordecreasedsupply,e.g.coronary
arteryspasm,coronaryembolism,anaemia,arrhythmias,
hypertension,orhypotension
Type3
Suddenunexpectedcardiacdeath,includingcardiacarrest,
oftenwithsymptomssuggestiveofmyocardialischaemia,
accompaniedbypresumablynewSTelevation,ornewLBBB,or
evidenceoffreshthrombusinacoronaryarterybyangiography
and/oratautopsy,butdeathoccurringbeforebloodsamples
couldbeobtained,oratatimebeforetheappearanceof
cardiacbiomarkersintheblood
Type4a
MyocardialinfarctionassociatedwithPCI
Type4b
Myocardialinfarctionassociatedwithstentthrombosisas
documentedbyangiographyoratautopsy
Type5
MyocardialinfarctionassociatedwithCABG

Table2Elevationsoftroponinintheabsenceofovertischemic
heartdisease
Cardiaccontusion,orothertraumaincludingsurgery,ablation,
pacing,etc.
Congestiveheartfailure―acuteandchronic
Aorticdissection
Aorticvalvedisease
Hypertrophiccardiomyopathy
Tachy-orbradyarrhythmias,orheartblock
Apicalballooningsyndrome
Rhabdomyolysiswithcardiacinjury
Pulmonaryembolism,severepulmonaryhypertension
Renalfailure
Acuteneurologicaldisease,includingstrokeorsubarachnoid
haemorrhage
Infiltrativediseases,e.g.amyloidosis,haemochromatosis,
sarcoidosis,andscleroderma
Inflammatorydiseases,e.g.myocarditisormyocardialextension
ofendo-/pericarditis
Drugtoxicityortoxins
Criticallyillpatients,especiallywithrespiratoryfailureorsepsis
Burns,especiallyifaffecting.30%ofbodysurfacearea
Extremeexertion
ModifiedfromJaffeetal.,4andFrenchandWhite.5

Table3ECGmanifestationsofacutemyocardialischaemia
（inabsenceofLVHandLBB
STelevation
NewSTelevationattheJ-pointintwocontiguousleadswith
thecut-offpoints:0.2mVinmenor0.15mVinwomenin
leadsV2CV3and/or0.1mVinotherleads
STdepressionandT-wavechanges
Newhorizontalordown-slopingSTdepression0.05mVintwo
contiguousleads;and/orTinversion0.1mVintwo
contiguousleadswithprominentR-waveorR/Sratio.1
Table4ECGchangesassociatedwithpriormyocardial
infarction
AnyQ-waveinleadsV2CV30.02sorQScomplexinleadsV2
andV3
Q-wave0.03sand0.1mVdeeporQScomplexinleadsI,II,
aVL,aVF,orV4CV6inanytwoleadsofacontiguouslead
grouping（I,aVL,V6;V4CV6;II,III,andaVF）a
R-wave0.04sinV1CV2andR/S1withaconcordantpositive
T-waveintheabsenceofaconductiondefect
aThesamecriteriaareusedforsupplementalleadsV7CV9,andforthe
Cabrerafrontalplaneleadgrouping.
2年前是最新的
这是2008年ESC欧洲心脏病学会年会上的，地点是德国慕尼黑，会议时间是2008年8月30日至2008年9月3日。最新的，超进展。
chengong2007wrote:
这是2008年ESC欧洲心脏病学会年会上的，地点是德国慕尼黑，会议时间是2008年8月30日至2008年9月3日。最新的，超进展。

很遗憾，不是最新的，下文发布在ESC的官方网站上：
GiventheconsiderableadvancesinthemanagementofAMIsincethen,theESC,ACCandAmericanHeartAssociationjoinedtheWorldHeartFederationinaGlobalTaskForce-composedofexpertsinthefieldsofbiomarkers,ECG,imaging,interventionandclinicalinvestigation-toproduceanewupdatedconsensusdocument.Thiswaspublishedin2007-andreviewedinaGuidelinesSymposiumonSunday.

所以还是一年前的全球共识，只不过在今年ESC年会上又做了回顾，如有疑问可以到下面的网址（ESC官方网站）看看：
http://www.escardio.org/congresses/esc2008/news/Pages/Universal-definition-myocardial-infarction.aspx
michel95su，多谢！
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