Myocardial infarction is the most common form of cardiovascular disease worldwide, claiming over 9 million lives per year. As such, understanding the pathophysiology, epidemiology, signs, diagnostic methods, management, and prevention strategies of the disease is vital for the modern day physician and patient in the hopes of reducing its detrimental impact on society. Myocardial infarction is the result of a set of complex and multifactorial components which play a role into the pathogenesis of the disease. The commonest manifestation of myocardial infarction presents as atherosclerotic coronary artery disease, which is becoming more prevalent in today’s communities. For this reason, prevention of myocardial infarction must be stressed, especially in a world with changing demographics and dynamic transformations in the lifestyles of individuals. The current review outlines the pathophysiological, epidemiological, and diagnostic components of myocardial infarction a), highlights the management and prevention of the disease b), introduces challenges faced in the prevention of the disease c) and emphasizes the need for addressing these challenges with the aid of both, social and medical sectors of society d). These challenges involve the efficient integration of cardiac rehabilitation in patients with myocardial infarction (d1), the empowerment of individuals and patients to take the initiative in making radical and healthy lifestyle changes (d2) and understanding the unique risk profile of young adults with the hopes of integrating efficient primary preventive measures (d3).
References
[1]
WHO (2021) Cardiovascular Diseases (CVDs). https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)
[2]
Ye, Q., Zhang, J. and Ma, L. (2020) Predictors of All-Cause 1-Year Mortality in Myocardial Infarction Patients. Medicine, 99, e21288. https://doi.org/10.1097/md.0000000000021288
[3]
Foundation, B.H. (2021) UK Factsheet. British Heart Foundation.
[4]
Thygesen, K., Alpert, J.S., Jaffe, A.S., Chaitman, B.R., Bax, J.J., Morrow, D.A., et al. (2018) Fourth Universal Definition of Myocardial Infarction. Journal of the American College of Cardiology, 72, 2231-2264. https://doi.org/10.1016/j.jacc.2018.08.1038
[5]
Barstow, C., Rice, M. and McDivitt, J. (2017) Acute Coronary Syndrome: Diagnostic Evaluation. AFP Journal, 95, 170-177.
[6]
Tamis-Holland, J.E., Jneid, H., Reynolds, H.R., Agewall, S., Brilakis, E.S., Brown, T.M., et al. (2019) Contemporary Diagnosis and Management of Patients with Myocardial Infarction in the Absence of Obstructive Coronary Artery Disease: A Scientific Statement from the American Heart Association. Circulation, 139, e891-e908. https://doi.org/10.1161/cir.0000000000000670
[7]
Sweis, R. and Jivan, A. (2020) Acute Myocardial Infarction. MSD Manual Professional Version.
Arnett, D., Blumenthal, R. and Albert, M. (2019) 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation, 140, 596–646.
[10]
Piepoli, M.F., Corrà, U., Dendale, P., Frederix, I., Prescott, E., Schmid, J.P., et al. (2016) Challenges in Secondary Prevention after Acute Myocardial Infarction: A Call for Action. European Journal of Preventive Cardiology, 23, 1994-2006. https://doi.org/10.1177/2047487316663873
[11]
Nikolaos, N.F. (2015) Pathophysiology of Myocardial Infarction. Albert Einstein College of Medicine.
[12]
Daniele, G.C. (2017) The Pathophysiology of Myocardial Infarction-Induced Heart Failure. Universidade da Força Aérea.
[13]
Heusch, G. and Gersh, B. (2017) The Pathophysiology of Acute Myocardial Infarction and Strategies of Protection Beyond Reperfusion: A Continual Challenge. European Heart Journal, 38, 774-784.
[14]
Peng, H., Shindo, K., Donahue, R., et al. (2021) Adult Spiny Mice (Acomys) Exhibit Endogenous Cardiac Recovery in Response to Myocardial Infarction. University of Kentucky.
[15]
AHA (2021) Heart Disease and Stroke Statistics Update Fact Sheet.
[16]
Sushritha, K., Sharma, A., Suman, K., Harish Goud, P. and Akari, S. (2020) Epidemiological Study of Risk Factors in Myocardial Infarction Patients. Journal of Young Pharmacists, 12, s108-s112. https://doi.org/10.5530/jyp.2020.12s.57
[17]
Khan, M.A., Hashim, M.J., Mustafa, H., Baniyas, M.Y., Al Suwaidi, S.K.B.M., AlKatheeri, R., et al. (2020) Global Epidemiology of Ischemic Heart Disease: Results from the Global Burden of Disease Study. Cureus, 12, e9349. https://doi.org/10.7759/cureus.9349
[18]
Centers of Disease Control and Prevention (2020) Heart Disease Facts. https://www.cdc.gov/heartdisease/facts.htm
[19]
Per, A., Lawesson, S.S. and Karlsson, J.E. (2018) Characteristics of Patients with Acute Myocardial Infarction Contacting Primary Healthcare before Hospitalisation: A Cross-Sectional Study. BMC Family Practice—Research Article, Östergötland.
[20]
Ojha, N. and Dhamoon, A. (2021) Myocardial Infarction. StatPearls.
[21]
Salimi, M., Hochkirchen, B. and Nawid, S. (2021) Myocardial Infarction. https://next.amboss.com/us/article/wS0hbf#saatNQ
[22]
Newson, L. and Gronow, H. (2016) Cardiovascular History and Examination. https://patient.info/doctor/cardiovascular-history-and-examination
[23]
Tcheng, J., Ong, P. and Watson, T. (2018) Prehospital Diagnosis and Management of Acute Myocardial Infarction. In: Watson, T.J., Ong, P.J.L. and Tcheng, J.E., Eds., Primary Angioplasty: A Practical Guide, Springer, 15-29.
[24]
Sabesan, M. (2015) Diagnostic Markers of Acute Myocardial Infarction. Sri Ramachandra University.
[25]
Wang, X.-Y., Zhang, F., Zhang, C. and Zheng, L.R. (2019) The Biomarkers for Acute Myocardial Infarction and Heart Failure.
[26]
Montecucco, F., Carbone, F. and Schindler, T.H. (2015) Pathophysiology of ST-Segment Elevation Myocardial Infarction: Novel Mechanisms and Treatments. European Heart Journal, 37, 1268-1283. https://doi.org/10.1093/eurheartj/ehv592
[27]
Bangalore, S., Gupta, N., Guo, Y., Lala, A., Balsam, L., Roswell, R.O., et al. (2015) Outcomes with Invasive vs Conservative Management of Cardiogenic Shock Complicating Acute Myocardial Infarction. The American Journal of Medicine, 128, 601-608. https://doi.org/10.1016/j.amjmed.2014.12.009
[28]
Bainey, K.R., Alemayehu, W., Welsh, R.C., Kumar, A., King, S.B. and Kirtane, A.J. (2021) Long-Term Clinical Outcomes Following Revascularization in High-Risk Coronary Anatomy Patients with Stable Ischemic Heart Disease. Journal of the American Heart Association, 10, Article 18104. https://doi.org/10.1161/jaha.120.018104
[29]
Wolff, G., Dimitroulis, D., Andreotti, F., Kołodziejczak, M., Jung, C., Scicchitano, P., et al. (2017) Survival Benefits of Invasive versus Conservative Strategies in Heart Failure in Patients with Reduced Ejection Fraction and Coronary Artery Disease. Circulation: Heart Failure, 10, Article 3255. https://doi.org/10.1161/circheartfailure.116.003255
[30]
Bainey, K.R., Engstrøm, T., Smits, P.C., Gershlick, A.H., James, S.K., Storey, R.F., et al. (2020) Complete vs Culprit-Lesion-Only Revascularization for ST-Segment Elevation Myocardial Infarction. JAMA Cardiology, 5, Article 881. https://doi.org/10.1001/jamacardio.2020.1251
[31]
Sykes, R., Doherty, D., Mangion, K., Morrow, A. and Berry, C. (2021) What an Interventionalist Needs to Know about MI with Non-Obstructive Coronary Arteries. Interventional Cardiology Review, 16, e10. https://doi.org/10.15420/icr.2021.10
[32]
Abdu, F.A., Mohammed, A., Liu, L., Xu, Y. and Che, W. (2020) Myocardial Infarction with Nonobstructive Coronary Arteries (MINOCA): A Review of the Current Position. Cardiology, 145, 543-552. https://doi.org/10.1159/000509100
[33]
Karunathilake, S.P. and Ganegoda, G.U. (2018) Secondary Prevention of Cardiovascular Diseases and Application of Technology for Early Diagnosis. BioMed Research International, 2018, 1-9. https://doi.org/10.1155/2018/5767864
[34]
AHA (2021) ASCVD Risk Estimator. https://tools.acc.org/ldl/ascvd_risk_estimator/index.html#!/calulate/estimator/
[35]
Arnett, D.K., Blumenthal, R.S. and Albert, M.A. (2019) 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation, 140, e596-e646.
[36]
Karunathilake, S.P. and Ganegoda, G.U. (2018) Secondary Prevention of Cardiovascular Diseases and Application of Technology for Early Diagnosis. BioMed Research International, 2018, 1-9. https://doi.org/10.1155/2018/5767864
[37]
Mahajan, S., Valero-Elizondo, J., Khera, R., Desai, N.R., Blankstein, R., Blaha, M.J., et al. (2019) Variation and Disparities in Awareness of Myocardial Infarction Symptoms among Adults in the United States. JAMA Network Open, 2, e1917885. https://doi.org/10.1001/jamanetworkopen.2019.17885
[38]
Nehme, Z., Andrew, E., Bernard, S., Patsamanis, H., Cameron, P., Bray, J.E., et al. (2016) Impact of a Public Awareness Campaign on Out-of-Hospital Cardiac Arrest Incidence and Mortality Rates. European Heart Journal, 38, ehw500. https://doi.org/10.1093/eurheartj/ehw500
[39]
Agency for Healthcare Research and Quality (2021) TAKEheart: AHRQ’s Initiative to Increase Use of Cardiac Rehabilitation. https://takeheart.ahrq.gov/case-cardiac-rehabilitation/challenge
[40]
Foundation, B.H. (2019) Cardiac Rehabilitation: The Big Picture. https://www.bhf.org.uk/for-professionals/healthcare-professionals/data-and-statistics/cardiac-rehabilitation-the-big-picture
[41]
Hansen, D., Piepoli, M.F. and Doehner, W. (2018) The Importance of Rehabilitation in the Secondary Prevention of Cardiovascular Disease. European Journal of Preventive Cardiology, 26, 273-276. https://doi.org/10.1177/2047487318809459
[42]
Gulati, R., Behfar, A., Narula, J., Kanwar, A., Lerman, A., Cooper, L., et al. (2020) Acute Myocardial Infarction in Young Individuals. Mayo Clinic Proceedings, 95, 136-156. https://doi.org/10.1016/j.mayocp.2019.05.001
[43]
Shah, N., Kelly, A., Cox, N., Wong, C. and Soon, K. (2016) Myocardial Infarction in the “Young”: Risk Factors, Presentation, Management and Prognosis. Heart, Lung and Circulation, 25, 955-960. https://doi.org/10.1016/j.hlc.2016.04.015
[44]
Gooding, H.C., Gidding, S.S., Moran, A.E., Redmond, N., Allen, N.B., Bacha, F., et al. (2020) Challenges and Opportunities for the Prevention and Treatment of Cardiovascular Disease among Young Adults: Report from a National Heart, Lung, and Blood Institute Working Group. Journal of the American Heart Association, 9, Article 16115. https://doi.org/10.1161/jaha.120.016115
