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European Heart Journal 2007 28(20):2525-2538; doi:10.1093/eurheartj/ehm355
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© The European Society of Cardiology, the American College of Cardiology Foundation, the American Heart Association, and the World Heart Federation 2007. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Universal definition of myocardial infarction

Kristian Thygesen, Joseph S. Alpert and Harvey D. White on behalf of the Joint ESC/ACCF/AHA/WHF Task Force for the Redefinition of Myocardial Infarction

Task Force Members, Kristian Thygesen, Chairpersons*, Joseph S. Alpert*, Harvey D. White*, Biomarker Group, Allan S. Jaffe, Co-ordinator, Fred S. Apple, Marcello Galvani, Hugo A. Katus, L. Kristin Newby, Jan Ravkilde, ECG Group, Bernard Chaitman, Co-ordinator, Peter M. Clemmensen, Mikael Dellborg, Hanoch Hod, Pekka Porela, Imaging Group, Richard Underwood, Co-ordinator, Jeroen J. Bax, George A. Beller, Robert Bonow, Ernst E. Van Der Wall, Intervention Group, Jean-Pierre Bassand, Co-ordinator, William Wijns, Co-ordinator, T. Bruce Ferguson, Philippe G. Steg, Barry F. Uretsky, David O. Williams, Clinical Investigation Group, Paul W. Armstrong, Co-ordinator, Elliott M. Antman, Keith A. Fox, Christian W. Hamm, E. Magnus Ohman, Maarten L. Simoons, Global Perspective Group, Philip A. Poole-Wilson, Co-ordinator, Enrique P. Gurfinkel, José-Luis Lopez-Sendon, Prem Pais, Shanti Mendis{ddagger}, Jun-Ren Zhu, Implementation Group, Lars C. Wallentin, Co-ordinator, Francisco Fernández-Avilés, Kim M. Fox, Alexander N. Parkhomenko, Silvia G. Priori, Michal Tendera and Liisa-Maria Voipio-Pulkki

(Denmark)
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(Denmark)
(USA)
(Denmark)
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(Israel)
(Finland)
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(France)
(Belgium)
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(France)
(USA)
(USA)
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(USA)
(UK)
(Germany)
(USA)
(The Netherlands)
(UK)
(Argentina)
(Spain)
(India)
(Switzerland)
(China)
(Sweden)
(Spain)
(UK)
(Ukraine)
(Italy)
(Poland)
(Finland)

ESC Committee for Practice Guidelines, Alec Vahanian, Chair, A. John Camm, Raffaele De Caterina, Veronica Dean, Kenneth Dickstein, Gerasimos Filippatos, Christian Funck-Brentano, Irene Hellemans, Steen Dalby Kristensen, Keith McGregor, Udo Sechtem, Sigmund Silber, Michal Tendera, Petr Widimsky and José Luis Zamorano

(France)
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(France)
(Norway)
(Greece)
(France)
(The Netherlands)
(Denmark)
(France)
(Germany)
(Germany)
(Poland)
(Czech Republic)
(Spain)

Document Reviewers, Joao Morais, Review Co-ordinator, Sorin Brener, Robert Harrington, David Morrow, Udo Sechtem, Michael Lim, Marco A. Martinez-Rios, Steve Steinhubl, Glen N. Levine, W. Brian Gibler, David Goff, Marco Tubaro, Darek Dudek and Nawwar Al-Attar

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* Corresponding authors/co-chairpersons. Professor Kristian Thygesen, Department of Medicine and Cardiology, Aarhus University Hospital, Tage Hansens, Gade 2, DK-8000 Aarhus C, Denmark. Tel: +45 89 49 76 14; fax: +45 89 49 76 19. E-mail: Kristian.Thygesen@as.aaa.dk. Professor Joseph Alpert, Department of Medicine, University of Arizona College of Medicine, 1501 N. Campbell Ave, PO Box 245017, Tucson, AZ 85724-5017, USA. Tel: +1 520 626 6138; fax: +1 520 626 6604. E-mail: jalpert@email.arizona.edu. Professor Harvey White, Green Lane Cardiovascular Service, Auckland City Hospital, Private Bag 92024, 1030 Auckland, New Zealand. Tel: +64 96309992; fax: +64 96309915. E-mail: harveyw@adhb.govt.nz


The recommendations set forth in this report are those of the Task Force Members and do not necessarily reflect the official position of the American College of Cardiology.

{ddagger} Dr Shanti Mendis of the WHO participated in the task force in her personal capacity, but this does not represent WHO approval of this document at the present time. Back

This article has been copublished in the October II (Vol. 28 no. 20), 2007, issue of the European Heart Journal (also available on the Web site of the European Society of Cardiology at www.escardio.org), the November 27, 2007, issue of Circulation (also available on the Web site of the American Heart Association at my.americanheart.org), and the November 27, 2007, issue of the Journal of the American College of Cardiology (also available on the Web site of the American College of Cardiology at www.acc.org).

This document was approved by the European Society . . . [Full Text of this Article]


    Introduction
 
Clinical features of ischaemia
Pathology
Clinical classification of myocardial infarction

    Biomarker evaluation
 
Reinfarction

    Electrocardiographic detection of myocardial infarction
 
ECG abnormalities of myocardial ischaemia that may evolve to myocardial infarction
Prior myocardial infarction
Conditions that confound the ECG diagnosis of myocardial infarction
Reinfarction
Coronary revascularization

    Imaging techniques
 
Echocardiography
Radionuclide imaging
Magnetic resonance imaging
X-Ray computed tomography
Application in the acute phase of myocardial infarction
Application in the healing or healed phase of myocardial infarction

    Myocardial infarction associated with revascularization procedures
 
Diagnostic criteria for myocardial infarction with PCI
Diagnostic criteria for myocardial infarction with CABG

    Definition of myocardial infarction in clinical investigations
 

    Public policy implications of redefinition of myocardial infarction
 

    Global perspectives of the redefinition of myocardial infarction
 

    Conflicts of interest
 

    Acknowledgements
 

    Footnotes
 

    References
 

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Universal definition of myocardial infarction: Kristian Thygesen, Joseph S. Alpert and Harvey D. White on behalf of the Joint ESC/ACCF/AHA/WHF Task Force for the Redefinition of Myocardial Infarction
Task Force Members, Kristian Thygesen, Joseph S. Alpert, Harvey D. White, Biomarker Group, Allan S. Jaffe, Fred S. Apple, Marcello Galvani, Hugo A. Katus, L. Kristin Newby, Jan Ravkilde, ECG Group, Bernard Chaitman, Peter M. Clemmensen, Mikael Dellborg, Hanoch Hod, Pekka Porela, Imaging Group, Richard Underwood, Jeroen J. Bax, George A. Beller, Robert Bonow, Ernst E. Van Der Wall, Intervention Group, Jean-Pierre Bassand, William Wijns, T. Bruce Ferguson, Philippe G. Steg, Barry F. Uretsky, David O. Williams, Clinical Investigation Group, Paul W. Armstrong, Elliott M. Antman, Keith A. Fox, Christian W. Hamm, E. Magnus Ohman, Maarten L. Simoons, Global Perspective Group, Philip A. Poole-Wilson, Enrique P. Gurfinkel, José-Luis Lopez-Sendon, Prem Pais, Shanti Mendis, Jun-Ren Zhu, Implementation Group, Lars C. Wallentin, Francisco Fernández-Avilés, Kim M. Fox, Alexander N. Parkhomenko, Silvia G. Priori, Michal Tendera, Liisa-Maria Voipio-Pulkki, ESC Committee for Practice Guidelines, Alec Vahanian, A. John Camm, Raffaele De Caterina, Veronica Dean, Kenneth Dickstein, Gerasimos Filippatos, Christian Funck-Brentano, Irene Hellemans, Steen Dalby Kristensen, Keith McGregor, Udo Sechtem, Sigmund Silber, Michal Tendera, Petr Widimsky, José Luis Zamorano, Document Reviewers, Joao Morais, Sorin Brener, Robert Harrington, David Morrow, Udo Sechtem, Michael Lim, Marco A. Martinez-Rios, Steve Steinhubl, Glen N. Levine, W. Brian Gibler, David Goff, Marco Tubaro, Darek Dudek, and Nawwar Al-Attar
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K. Thygesen, J. S. Alpert, A. S. Jaffe, H. D. White, and On behalf of the Joint ESC/ACCF/AHA/WHF Task Force
Intraoperative myocardial infarction in non-cardiac surgery: is a universal definition feasible? reply
Eur. Heart J., February 2, 2008; 29(4): 567 - 568.
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Clin. Chem.Home page
P. Collinson, K. Pulkki, J. Suvisaari, J. Ravkilde, A. Stavljenic-Rukavina, A. Hammerer-Lercher, H. Baum, M. P. van Dieijen-Visser, and P. H. Laitinen
How Well Do Laboratories Follow Guidelines on Cardiac Markers? The Cardiac Marker Guideline Uptake in Europe Study
Clin. Chem., February 1, 2008; 54(2): 448 - 449.
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