Fifth Universal Definition of Myocardial Infarction (2026) — ESC/ACC/AHA/WHF Task Force
The numbered types are gone. After eighteen years of type 1 to type 5, the fifth definition names infarctions by cause: primary (an acute coronary problem, from plaque rupture to dissection, spasm or embolism), secondary (supply and demand pulled apart by another acute illness), and procedure-related (within 30 days of a cardiac procedure, on one set of criteria for percutaneous and surgical alike). Sex-specific 99th-percentile troponin limits become mandatory, a procedure-related infarction is confirmed by an angiographic complication or by imaging rather than by a troponin threshold alone, MINOCA is renamed and demoted to a working diagnosis, unstable angina survives as its own entity, and ICD-11 codes down to the aetiology ship with the document.
Cette recommandation cite 1 des 199 essais majeurs de notre registre de Cardiologie.
Primary myocardial infarction1
- 2019COMPLETECardiologie · Coronaire · RevascularisationChez 4.041 patients avec un STEMI et une maladie polyvasculaire, une revascularisation complète différée a réduit les décès CV ou IDM par rapport à la ICP de la lésion coupable seule.
Published since the guideline1
- 2026TARGET-CTCACardiologie · Coronaire · CT coronary angiographyTroponin in Acute Chest Pain to Risk Stratify and Guide EffecTive Use of Computed Tomography Coronary Angiography (TARGET-CTCA)