Troponins (ACCF Bundle)

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Diagnosis and Assessment Figure 2. Troponin Positivity and the Universal Definition of MI Troponin Positive 3 SCD Ischemic Classification of MI Type Myocardial infarction 2 1 Non-ACS ACS •  Classic AMI ▶▶ STEMI ▶▶ NSTEMI Noncoronary Coronary •  Hypoxia •  Global ischemia •  Hyperperfusion •  CT surgery •  Increased demand  (stable CAD lesion) •  Hypertension   (small vessel) •  Spasm •  Embolism •  Procedure related ▶▶ PCI 4 ▶▶ CT surgery 5 Type 1: Ischemic myocardial necrosis secondary to plaque rupture (ACS) Type 2: Ischemic myocardial necrosis not due to ACS   (eg, supply/demand mismatch, coronary spasm, embolism,   ↑ or ↓ BP, anemia, arrhythmia) Type 3: Sudden cardiac death Type 4: Procedure related  a) Secondary to PCI  b) From stent thrombosis Type 5: CABG related

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