Fourth universal definition of myocardial infarction (2018)

Kristian Thygesen, Joseph S. Alpert, Allan S. Jaffe, Bernard R. Chaitman, Jeroen J. Bax, David A. Morrow, Harvey D. White, Hans Mickley, Filippo Crea, Frans Van De Werf, Chiara Bucciarelli-Ducci, Hugo A. Katus, Fausto J. Pinto, Elliott M. Antman, Christian W. Hamm, Raffaele De Caterina, James L. Januzzi, Fred S Apple, Maria Angeles Alonso Garcia, S. Richard UnderwoodJohn M. Canty, Alexander R. Lyon, P. J. Devereaux, Jose Luis Zamorano, Bertil Lindahl, William S. Weintraub, L. Kristin Newby, Renu Virmani, Pascal Vranckx, Don Cutlip, Raymond J. Gibbons, Sidney C. Smith, Dan Atar, Russell V. Luepker, Rose Marie Robertson, Robert O. Bonow, P. Gabriel Steg, Patrick T. O’Gara, Keith A.A. Fox, David Hasdai, Victor Aboyans, Stephan Achenbach, Stefan Agewall, Thomas Alexander, Alvaro Avezum, Emanuele Barbato, Jean Pierre Bassand, Eric Bates, John A. Bittl, Güenter Breithardt, Héctor Bueno, Raffaele Bugiardini, Mauricio G. Cohen, George Dangas, James A. De Lemos, Victoria Delgado, Gerasimos Filippatos, Edward Fry, Christopher B. Granger, Sigrun Halvorsen, Mark A. Hlatky, Borja Ibanez, Stefan James, Adnan Kastrati, Christophe Leclercq, Kenneth W. Mahaffey, Laxmi Mehta, Christian Müller, Carlo Patrono, Massimo Francesco Piepoli, Daniel Piñeiro, Marco Roffi, Andrea Rubboli, Samin Sharma, Iain A. Simpson, Michael Tendera, Marco Valgimigli, Allard C. Van Der Wal, Stephan Windecker

Research output: Contribution to journalArticlepeer-review

1632 Scopus citations
Original languageEnglish (US)
Pages (from-to)237-269
Number of pages33
JournalEuropean heart journal
Volume40
Issue number3
DOIs
StatePublished - Jan 14 2019

Bibliographical note

Funding Information:
Algeria: Algerian Society of Cardiology, Mohamed Chettibi; Armenia: Armenian Cardiologists Association, Hamlet Hayrapetyan; Austria: Austrian Society of Cardiology, Franz Xaver Roithinger; Azerbaijan: Azerbaijan Society of Cardiology, Farid Aliyev; Belarus: Belorussian Scientific Society of Cardiologists, Volha Sujayeva; Belgium: Belgian Society of Cardiology, Marc J. Claeys; Bosnia and Herzegovina: Association of Cardiologists of Bosnia and Herzegovina, Elnur Smajić; Czech Republic: Czech Society of Cardiology, Petr Kala; Denmark: Danish Society of Cardiology, Kasper Karmak Iversen; Egypt: Egyptian Society of Cardiology, Ehab El Hefny; Estonia: Estonian Society of Cardiology, Toomas Marandi; Finland: Finnish Cardiac Society, Pekka Porela; The Former Yugoslav Republic of Macedonia: Macedonian FYR Society of Cardiology, Slobodan Antov; France: French Society of Cardiology, Martine Gilard; Germany: German Cardiac Society, Stefan Blankenberg; Greece: Hellenic Society of Cardiology, Periklis Davlouros; Iceland: Icelandic Society of Cardiology, Thorarinn Gudnason; Israel: Israel Heart Society, Ronny Alcalai; Italy: Italian Federation of Cardiology, Furio Colivicchi; Kosovo: Kosovo Society of Cardiology, Shpend Elezi; Kyrgyzstan: Kyrgyz Society of Cardiology, Gulmira Baitova, Latvia: Latvian Society of Cardiology, Ilja Zakke; Lithuania: Lithuanian Society of Cardiology, Olivija Gustiene; Luxembourg: Luxembourg Society of Cardiology, Jean Beissel; Malta: Maltese Cardiac Society, Philip Dingli; Moldova: Moldavian Society of Cardiology, Aurel Grosu; The Netherlands: Netherlands Society of Cardiology, Peter Damman; Norway: Norwegian Society of Cardiology, Vibeke Juliebø; Poland: Polish Cardiac Society, Jacek Legutko; Portugal: Portuguese Society of Cardiology, Jo€ao Morais; Romania: Romanian Society of Cardiology, Gabriel Tatu-Chitoiu; Russian Federation: Russian

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1. Hammer A. Ein Fall von thrombotischem Verschlusse einer der Kranzarterien des Herzens. Wien Med Wschr 1878;28:97–102. 2. Obraztzow VP, Straschesko ND. Zur Kenntnis der Thrombose der Koronararterien des Herzens. Z Klin Med 1910;71:116–132. 3. Herrick JB. Clinical features of sudden obstruction of the coronary arteries. JAMA 1912;59:2015–2022. 4. Friedberg CK, Horn H. Acute myocardial infarction not due to coronary artery occlusion. JAMA 1939;112:1675–1679. 5. World Health Organization. Working Group on the Establishment of Ischemic Heart Disease Registers. Report of the Fifth Working Group, Copenhagen. In: Report No. Eur 8201 (5). Geneva: World Health Organization; 1971. 6. Report of the Joint International Society and Federation of Cardiology/World Health Organization task force on standardization of clinical nomenclature. Nomenclature and criteria for diagnosis of ischemic heart disease. Circulation 1979;59:607–609. 7. Tunstall-Pedoe H, Kuulasmaa K, Amouyel P, Arveiler D, Rajakangas AM, Pajak A. Myocardial infarction and coronary deaths in the World Health Organization MONICA Project. Registration procedures, event rates, and case-fatality rates in 38 populations from 21 countries in four continents. Circulation 1994;90:583–612. 8. Luepker RV, Apple FS, Christenson RH, Crow RS, Fortmann SP, Goff D, Goldberg RJ, Hand MM, Jaffe AS, Julian DG, Levy D, Manolio T, Mendis S, Mensah G, Pajak A, Prineas RJ, Reddy KS, Roger VL, Rosamond WD, Shahar E, Sharrett AR, Sorlie P, Tunstall-Pedoe H. Case definitions for acute coronary heart disease in epidemiology and clinical research studies: A statement from the AHA Council on Epidemiology and Prevention; AHA Statistics Committee; World Heart Federation Council on Epidemiology and Prevention; the European Society of Cardiology Working Group on Epidemiology and Prevention; Centers for Disease Control and Prevention; and the National Heart, Lung, and Blood Institute. Circulation 2003;108:2543–2549. 9. The Joint European Society of Cardiology/American College of Cardiology Committee. Myocardial infarction redefined—a consensus document of the Joint European Society of Cardiology/American College of Cardiology Committee for the Redefinition of Myocardial Infarction. Eur Heart J 2000;21:1502–1513; J Am Coll Cardiol 2000;36:959–969. 10. Thygesen K, Alpert JS, White HD; Joint ESC/ACC/AHA/WHF Task Force for the Redefinition of Myocardial Infarction. Universal definition of myocardial infarction. Eur Heart J 2007;28:2525–2538; Circulation 2007;116:2634–2653; J Am Coll Cardiol 2007;50:2173–2195. 11. Mendis S, Thygesen K, Kuulasmaa K, Giampaoli S, M€ahönen M, Ngu Blackett K, Lisheng L; Writing group on behalf of the participating experts of the WHO con-sultation for revision of WHO definition of myocardial infarction. World Health Organization definition of myocardial infarction: 2008-09 revision. Int J Epidemiol 2011;40:139–146. 12. Thygesen K, Alpert JS, Jaffe AS, Simoons ML, Chaitman BR, White HD; Writing Group on the Joint ESC/ACC/AHA/WHF Task Force for the Universal Definition of Myocardial Infarction. Third universal definition of myocardial

Funding Information:
VC 2018 European Society of Cardiology, American College of Cardiology, American Heart Association, Inc., and World Heart Foundation. The articles are identical except for minor stylistic and spelling differences in keeping with each journal’s style. Any citation can be used when citing this article.

Funding Information:
Figure 1 History of documents on the definition of myocardial infarction. ACC = American College of Cardiology; AHA = American Heart Association; ESC = European Society of Cardiology; ISFC = International Society and Federation of Cardiology; MONICA = MONItoring of trends and determinants in CArdiovascular disease; NHLBI = National Heart, Lung, and Blood Institute; UDMI = Universal Definition of Myocardial Infarction; WHF = World Heart Federation; WHO = World Health Organization.

Keywords

  • Cardiac procedural myocardial injury
  • Cardiac troponin
  • Expert Consensus Document
  • High sensitivity cardiac troponin
  • Myocardial infarction
  • Myocardial infarction with non-obstructive coronary arteries (MINOCA)
  • Myocardial injury
  • Prior myocardial infarction
  • Re-infarction
  • Recurrent myocardial infarction
  • Silent myocardial infarction
  • Takotsubo syndrome
  • Type 1 MI
  • Type 2 MI
  • Type 3 MI
  • Type 4a MI
  • Type 4b MI
  • Type 4c MI
  • Type 5 MI

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