The universal classification is an independent predictor of long-term outcomes in acute myocardial infarction

Abstract Background The long-term outcomes of patients with acute myocardial infarction (AMI) according to the universal classification (UC) are unknown. We investigated whether the outcome of these patients is better predicted by the UC than the ST-segment classification (STC). Methods We conducted a retrospective study of 348 consecutive patients with AMI with mean follow-up of 30.6 months. The primary outcome was major adverse cardiovascular events (MACE) [composite of all causes of death and AMI]. Results The study included ST-segment elevation (STEMI)=168 (48%), non-ST-segment elevation (NSTEMI)=180 (52%), Type 1=278 (80%), Type 2=55 (15.8%), Type 3=5 (1.4%), Type 4a=2 (0.6%), Type 4b=5 (1.4%), and Type 5=3 (0.9%). During follow-up, 102 (29.3%) patients had MACE, 80 (23%) patients died, and 31 (8.9%) had an AMI. The adjusted risk of MACE was similar for NSTEMI and STEMI (HR 1.26, 95% CI 0.77–2.03, P =.35) but was significantly lower for patients with Type 2 AMI as compared to Type 1 (HR 0.44, 95% CI 0.21–0.90, P =.02). The UC, peak troponin levels, discharge glomerular filtration rate