Universal MI definition update for cardiovascular disease

Harvey White, Kristian Thygesen, Joseph S. Alpert, Allan Jaffe

Research output: Contribution to journalReview articlepeer-review

27 Scopus citations


The new third universal definition of myocardial infarction (MI) is based on troponin elevation together with ischemic symptoms, ischemic ECG changes, and imaging evidence. MIs are classified into five types as to whether they are spontaneous, secondary to imbalance between coronary artery blood supply and demand, related to sudden death, or related to revascularization procedures. The definition is based on a rise and/or fall in troponin levels occurring in a clinical setting. There have been modifications over previous definitions with adding intracoronary thrombus as a criterion, adding a new type of MI type 4c, and raising the cutpoint for the diagnosis of MI related to percutaneous coronary intervention to five times the 99th percentile upper reference limit and requiring evidence of ischemia or angiographic complications. In clinical practice, trials, and registries, different definitions are used. There is a need for consistency with regard to the definition of MI and the universal definition should be implemented.

Original languageEnglish (US)
Article number492
JournalCurrent cardiology reports
Issue number6
StatePublished - Jun 2014


  • Cardiovascular disease
  • Myocardial infarction
  • Troponin
  • Universal definition

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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