UMMS Affiliation

Division of Cardiovascular Medicine, Department of Medicine

Publication Date


Document Type



Cardiology | Cardiovascular Diseases


BACKGROUND: The Wake-Up T2MI Registry is a retrospective cohort study investigating patients with type 2 myocardial infarction (T2MI), acute myocardial injury, and chronic myocardial injury. We aim to explore risk stratification strategies and investigate clinical characteristics, management, and short- and long-term outcomes in this high-risk, understudied population.

METHODS: From 1 January 2009 to 31 December 2010, 2846 patients were identified with T2MI or myocardial injury defined as elevated cardiac troponin I with at least one value above the 99th percentile upper reference limit and coefficient of variation of 10% ( > 40 ng/L) and meeting our inclusion criteria. Data of at least two serial troponin values will be collected from the electronic health records to differentiate between acute and chronic myocardial injury. The Fourth Universal Definition will be used to classify patients as having (a) T2MI, (b) acute myocardial injury, or (c) chronic myocardial injury during the index hospitalization. Long-term mortality data will be collected through data linkage with the National Death Index and North Carolina State Vital Statistics.

RESULTS: We have collected data for a total of 2205 patients as of November 2018. The mean age of the population was 65.6 +/- 16.9 years, 48% were men, and 64% were white. Common comorbidities included hypertension (71%), hyperlipidemia (35%), and diabetes mellitus (30%). At presentation, 40% were on aspirin, 38% on beta-blockers, and 30% on statins.

CONCLUSION: Improved characterization and profiling of this cohort may further efforts to identify evidence-based strategies to improve cardiovascular outcomes among patients with T2MI and myocardial injury.


acute myocardial injury, chronic myocardial injury, demand ischemia, myonecrosis, troponin, type 2 myocardial infarction

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© 2019 The Authors. Clinical Cardiology published by Wiley Periodicals, Inc. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

DOI of Published Version



Clin Cardiol. 2019 Jun;42(6):592-604. doi: 10.1002/clc.23182. Epub 2019 Apr 12. Link to article on publisher's site

Journal/Book/Conference Title

Clinical cardiology


Full author list omitted for brevity. For the full list of authors, see article.

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Creative Commons License

Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.