Accurate and rapid noninvasive discrimination of type 2 myocardial infarction (T2MI), caused by the supply-demand mismatch from type-1 myocardial infarction (T1MI), is essential as the treatment for the condition differed significantly. This study aims to determine whether novel cardiovascular biomarkers quantifying different pathophysiological pathways involved in T2MI/T1MI help doctors differ between T2MI and T1MI.

This multicenter, international prospective diagnostic study included a total of 5,887 patients with acute chest discomfort admitted to the emergency department. The primary objective of this study was to determine the efficacy of cardiovascular markers as an indicator to differ between T2MI and T1MI.

Of 5,887 patients included in the study, 1,106 (18.8%) patients had a diagnosis of MI. Of these, 860 patients (77.8%) had T1MI, and 246 (22.2%) had T2MI. The findings suggested that patients with T2MI had lower concentrations of biomarkers quantifying the cardiomyocyte injury compared to patients with T1MI. However, patients with T1MI had higher concentrations of biomarkers quantifying microvascular dysfunction, hemodynamic stress, and/or endothelial dysfunction.

The research concluded that novel cardiovascular biomarkers provided modest discriminations in quantifying hemodynamic stress, microvascular dysfunction, myocardial injury, and endothelial dysfunction in patients with type 2 and type 1 myocardial infarction.