ArticleCirculation2015
The Variation in Recovery: Role of Gender on Outcomes of Young AMI Patients (VIRGO) Classification System: A Taxonomy for Young Women With Acute Myocardial Infarction.
Abstract readComparative Study
In one paragraph
Article in Circulation, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers.
0numbers the graph read from it
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31citing papers in PubMed
–field-weighted citation impact
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
31 citing papers in PubMed.
- The women's heart health programme: a pilot trial of sex-specific cardiovascular management.BMC women's health · 2018Trial
- Silent Myocardial Infarction in Pregnancy Uncovered During Routine Antenatal Echocardiographic Screening.JACC. Case reports · 2026Article
- The Role of Serum Biomarkers for the Differential Diagnosis and Prognostic Assessment of Myocardial Infarction with Non-Obstructive Coronary Arteries: A Narrative Review.Journal of clinical medicine · 2026Review
- Gender, diversity, and inclusion in phenotypic and genetic characterization of acute coronary syndromes: rationale and design of the prospective multicentre GEDI-ACS registry.European heart journal open · 2026Article
- Review
- Causes of Myocardial Infarction in Younger Patients: Troponin-Elevation in Persons ≤65 Years Old in Olmsted County.Journal of the American College of Cardiology · 2025Article
- Type 2 myocardial infarction: challenges in diagnosis and treatment.European heart journal · 2025Review
- Short-Term Associations Between Ambient Ozone and Acute Myocardial Infarction Onset Among Younger Patients: Results From the VIRGO Study.GeoHealth · 2025Article
- Characteristics of Young Women Presenting With Acute Myocardial Infarction: The Prospective, Multicenter, Observational Young Women Presenting Acute Myocardial Infarction in France Study.Journal of the American Heart Association · 2024Observational
- Sex Differences in Coronary Artery Disease Characteristics Among Patients With Type 2 Myocardial Infarction.JACC. Advances · 2024Article
- Spectrum of Ischemic Heart Disease Throughout a Woman's Life Cycle.Methodist DeBakey cardiovascular journal · 2024Review
- Risk factor associations with individual myocardial infarction subtypes and acute non-ischemic myocardial injury in the Multi-Ethnic Study of Atherosclerosis (MESA): Design and rationale.American heart journal · 2023Article
- Review
- Imaging of heart disease in women: review and case presentation.European journal of nuclear medicine and molecular imaging · 2022Review
- Pregnancy-related acute myocardial infarction: a review of the recent literature.Clinical research in cardiology : official journal of the German Cardiac Society · 2022Review
- Sex-Specific Risk Factors Associated With First Acute Myocardial Infarction in Young Adults.JAMA network open · 2022Article
- Review
- Patients with COVID-19 who experience a myocardial infarction have complex coronary morphology and high in-hospital mortality: Primary results of a nationwide angiographic study.Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2021Article
- Analysis of Posttraumatic Stress Disorder, Depression, Anxiety, and Resiliency Within the Unique Population of Spontaneous Coronary Artery Dissection Survivors.Journal of the American Heart Association · 2020Article
- Wake Forest University long-term follow-up of type 2 myocardial infarction: The Wake-Up T2MI Registry.Clinical cardiology · 2019Article
Corrections and comments
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Authors and funding
18 authors.
Erica S SpatzFrom Section of Cardiovascular Medicine, Department of Internal Medicine (E.S.S., J.P.C., A.J.L., J.F.L., R.P.D., K.M., H.M.K.), Section of General Internal Medicine, Department of Internal Medicine (C.P.G., S.I.C.), Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine (L.A.C., C.P.G., H.M.K.), Yale Cardiovascular Research Group, Department of Internal Medicine (A.J.L.), and Department of Emergency Medicine (G.D., B.S.), Yale School of Medicine, New Haven, CT; Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, CT (E.S.S., S.Z., K.M.S., J.P.C., J.A.S.B.-F., J.F.L., H.B., R.P.D., K.M., H.M.K.); Department of Health Policy and Management, Yale School of Public Health, New Haven, CT (L.A.C., H.M.K.); Division of Cardiology, University of Colorado Anschutz Medical Campus, Aurora (F.A.M.); Division of Cardiology, Federal University of Sergipe, and the Clínica e Hospital São Lucas, Aracaju, Brazil (J.A.S.B.-F.); Department of Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain (H.B.); and University of Kansas City-Missouri and Saint Luke's Mid America Heart Institute, Kansas City (J.A.S.).
Leslie A CurryFrom Section of Cardiovascular Medicine, Department of Internal Medicine (E.S.S., J.P.C., A.J.L., J.F.L., R.P.D., K.M., H.M.K.), Section of General Internal Medicine, Department of Internal Medicine (C.P.G., S.I.C.), Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine (L.A.C., C.P.G., H.M.K.), Yale Cardiovascular Research Group, Department of Internal Medicine (A.J.L.), and Department of Emergency Medicine (G.D., B.S.), Yale School of Medicine, New Haven, CT; Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, CT (E.S.S., S.Z., K.M.S., J.P.C., J.A.S.B.-F., J.F.L., H.B., R.P.D., K.M., H.M.K.); Department of Health Policy and Management, Yale School of Public Health, New Haven, CT (L.A.C., H.M.K.); Division of Cardiology, University of Colorado Anschutz Medical Campus, Aurora (F.A.M.); Division of Cardiology, Federal University of Sergipe, and the Clínica e Hospital São Lucas, Aracaju, Brazil (J.A.S.B.-F.); Department of Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain (H.B.); and University of Kansas City-Missouri and Saint Luke's Mid America Heart Institute, Kansas City (J.A.S.).
Frederick A MasoudiFrom Section of Cardiovascular Medicine, Department of Internal Medicine (E.S.S., J.P.C., A.J.L., J.F.L., R.P.D., K.M., H.M.K.), Section of General Internal Medicine, Department of Internal Medicine (C.P.G., S.I.C.), Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine (L.A.C., C.P.G., H.M.K.), Yale Cardiovascular Research Group, Department of Internal Medicine (A.J.L.), and Department of Emergency Medicine (G.D., B.S.), Yale School of Medicine, New Haven, CT; Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, CT (E.S.S., S.Z., K.M.S., J.P.C., J.A.S.B.-F., J.F.L., H.B., R.P.D., K.M., H.M.K.); Department of Health Policy and Management, Yale School of Public Health, New Haven, CT (L.A.C., H.M.K.); Division of Cardiology, University of Colorado Anschutz Medical Campus, Aurora (F.A.M.); Division of Cardiology, Federal University of Sergipe, and the Clínica e Hospital São Lucas, Aracaju, Brazil (J.A.S.B.-F.); Department of Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain (H.B.); and University of Kansas City-Missouri and Saint Luke's Mid America Heart Institute, Kansas City (J.A.S.).
Shengfan ZhouFrom Section of Cardiovascular Medicine, Department of Internal Medicine (E.S.S., J.P.C., A.J.L., J.F.L., R.P.D., K.M., H.M.K.), Section of General Internal Medicine, Department of Internal Medicine (C.P.G., S.I.C.), Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine (L.A.C., C.P.G., H.M.K.), Yale Cardiovascular Research Group, Department of Internal Medicine (A.J.L.), and Department of Emergency Medicine (G.D., B.S.), Yale School of Medicine, New Haven, CT; Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, CT (E.S.S., S.Z., K.M.S., J.P.C., J.A.S.B.-F., J.F.L., H.B., R.P.D., K.M., H.M.K.); Department of Health Policy and Management, Yale School of Public Health, New Haven, CT (L.A.C., H.M.K.); Division of Cardiology, University of Colorado Anschutz Medical Campus, Aurora (F.A.M.); Division of Cardiology, Federal University of Sergipe, and the Clínica e Hospital São Lucas, Aracaju, Brazil (J.A.S.B.-F.); Department of Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain (H.B.); and University of Kansas City-Missouri and Saint Luke's Mid America Heart Institute, Kansas City (J.A.S.).
Kelly M StraitFrom Section of Cardiovascular Medicine, Department of Internal Medicine (E.S.S., J.P.C., A.J.L., J.F.L., R.P.D., K.M., H.M.K.), Section of General Internal Medicine, Department of Internal Medicine (C.P.G., S.I.C.), Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine (L.A.C., C.P.G., H.M.K.), Yale Cardiovascular Research Group, Department of Internal Medicine (A.J.L.), and Department of Emergency Medicine (G.D., B.S.), Yale School of Medicine, New Haven, CT; Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, CT (E.S.S., S.Z., K.M.S., J.P.C., J.A.S.B.-F., J.F.L., H.B., R.P.D., K.M., H.M.K.); Department of Health Policy and Management, Yale School of Public Health, New Haven, CT (L.A.C., H.M.K.); Division of Cardiology, University of Colorado Anschutz Medical Campus, Aurora (F.A.M.); Division of Cardiology, Federal University of Sergipe, and the Clínica e Hospital São Lucas, Aracaju, Brazil (J.A.S.B.-F.); Department of Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain (H.B.); and University of Kansas City-Missouri and Saint Luke's Mid America Heart Institute, Kansas City (J.A.S.).
Cary P GrossFrom Section of Cardiovascular Medicine, Department of Internal Medicine (E.S.S., J.P.C., A.J.L., J.F.L., R.P.D., K.M., H.M.K.), Section of General Internal Medicine, Department of Internal Medicine (C.P.G., S.I.C.), Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine (L.A.C., C.P.G., H.M.K.), Yale Cardiovascular Research Group, Department of Internal Medicine (A.J.L.), and Department of Emergency Medicine (G.D., B.S.), Yale School of Medicine, New Haven, CT; Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, CT (E.S.S., S.Z., K.M.S., J.P.C., J.A.S.B.-F., J.F.L., H.B., R.P.D., K.M., H.M.K.); Department of Health Policy and Management, Yale School of Public Health, New Haven, CT (L.A.C., H.M.K.); Division of Cardiology, University of Colorado Anschutz Medical Campus, Aurora (F.A.M.); Division of Cardiology, Federal University of Sergipe, and the Clínica e Hospital São Lucas, Aracaju, Brazil (J.A.S.B.-F.); Department of Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain (H.B.); and University of Kansas City-Missouri and Saint Luke's Mid America Heart Institute, Kansas City (J.A.S.).
Jeptha P CurtisFrom Section of Cardiovascular Medicine, Department of Internal Medicine (E.S.S., J.P.C., A.J.L., J.F.L., R.P.D., K.M., H.M.K.), Section of General Internal Medicine, Department of Internal Medicine (C.P.G., S.I.C.), Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine (L.A.C., C.P.G., H.M.K.), Yale Cardiovascular Research Group, Department of Internal Medicine (A.J.L.), and Department of Emergency Medicine (G.D., B.S.), Yale School of Medicine, New Haven, CT; Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, CT (E.S.S., S.Z., K.M.S., J.P.C., J.A.S.B.-F., J.F.L., H.B., R.P.D., K.M., H.M.K.); Department of Health Policy and Management, Yale School of Public Health, New Haven, CT (L.A.C., H.M.K.); Division of Cardiology, University of Colorado Anschutz Medical Campus, Aurora (F.A.M.); Division of Cardiology, Federal University of Sergipe, and the Clínica e Hospital São Lucas, Aracaju, Brazil (J.A.S.B.-F.); Department of Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain (H.B.); and University of Kansas City-Missouri and Saint Luke's Mid America Heart Institute, Kansas City (J.A.S.).
Alexandra J LanskyFrom Section of Cardiovascular Medicine, Department of Internal Medicine (E.S.S., J.P.C., A.J.L., J.F.L., R.P.D., K.M., H.M.K.), Section of General Internal Medicine, Department of Internal Medicine (C.P.G., S.I.C.), Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine (L.A.C., C.P.G., H.M.K.), Yale Cardiovascular Research Group, Department of Internal Medicine (A.J.L.), and Department of Emergency Medicine (G.D., B.S.), Yale School of Medicine, New Haven, CT; Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, CT (E.S.S., S.Z., K.M.S., J.P.C., J.A.S.B.-F., J.F.L., H.B., R.P.D., K.M., H.M.K.); Department of Health Policy and Management, Yale School of Public Health, New Haven, CT (L.A.C., H.M.K.); Division of Cardiology, University of Colorado Anschutz Medical Campus, Aurora (F.A.M.); Division of Cardiology, Federal University of Sergipe, and the Clínica e Hospital São Lucas, Aracaju, Brazil (J.A.S.B.-F.); Department of Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain (H.B.); and University of Kansas City-Missouri and Saint Luke's Mid America Heart Institute, Kansas City (J.A.S.).
Jose Augusto Soares Barreto-FilhoFrom Section of Cardiovascular Medicine, Department of Internal Medicine (E.S.S., J.P.C., A.J.L., J.F.L., R.P.D., K.M., H.M.K.), Section of General Internal Medicine, Department of Internal Medicine (C.P.G., S.I.C.), Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine (L.A.C., C.P.G., H.M.K.), Yale Cardiovascular Research Group, Department of Internal Medicine (A.J.L.), and Department of Emergency Medicine (G.D., B.S.), Yale School of Medicine, New Haven, CT; Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, CT (E.S.S., S.Z., K.M.S., J.P.C., J.A.S.B.-F., J.F.L., H.B., R.P.D., K.M., H.M.K.); Department of Health Policy and Management, Yale School of Public Health, New Haven, CT (L.A.C., H.M.K.); Division of Cardiology, University of Colorado Anschutz Medical Campus, Aurora (F.A.M.); Division of Cardiology, Federal University of Sergipe, and the Clínica e Hospital São Lucas, Aracaju, Brazil (J.A.S.B.-F.); Department of Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain (H.B.); and University of Kansas City-Missouri and Saint Luke's Mid America Heart Institute, Kansas City (J.A.S.).
Julianna F LampropulosFrom Section of Cardiovascular Medicine, Department of Internal Medicine (E.S.S., J.P.C., A.J.L., J.F.L., R.P.D., K.M., H.M.K.), Section of General Internal Medicine, Department of Internal Medicine (C.P.G., S.I.C.), Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine (L.A.C., C.P.G., H.M.K.), Yale Cardiovascular Research Group, Department of Internal Medicine (A.J.L.), and Department of Emergency Medicine (G.D., B.S.), Yale School of Medicine, New Haven, CT; Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, CT (E.S.S., S.Z., K.M.S., J.P.C., J.A.S.B.-F., J.F.L., H.B., R.P.D., K.M., H.M.K.); Department of Health Policy and Management, Yale School of Public Health, New Haven, CT (L.A.C., H.M.K.); Division of Cardiology, University of Colorado Anschutz Medical Campus, Aurora (F.A.M.); Division of Cardiology, Federal University of Sergipe, and the Clínica e Hospital São Lucas, Aracaju, Brazil (J.A.S.B.-F.); Department of Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain (H.B.); and University of Kansas City-Missouri and Saint Luke's Mid America Heart Institute, Kansas City (J.A.S.).
Hector BuenoFrom Section of Cardiovascular Medicine, Department of Internal Medicine (E.S.S., J.P.C., A.J.L., J.F.L., R.P.D., K.M., H.M.K.), Section of General Internal Medicine, Department of Internal Medicine (C.P.G., S.I.C.), Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine (L.A.C., C.P.G., H.M.K.), Yale Cardiovascular Research Group, Department of Internal Medicine (A.J.L.), and Department of Emergency Medicine (G.D., B.S.), Yale School of Medicine, New Haven, CT; Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, CT (E.S.S., S.Z., K.M.S., J.P.C., J.A.S.B.-F., J.F.L., H.B., R.P.D., K.M., H.M.K.); Department of Health Policy and Management, Yale School of Public Health, New Haven, CT (L.A.C., H.M.K.); Division of Cardiology, University of Colorado Anschutz Medical Campus, Aurora (F.A.M.); Division of Cardiology, Federal University of Sergipe, and the Clínica e Hospital São Lucas, Aracaju, Brazil (J.A.S.B.-F.); Department of Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain (H.B.); and University of Kansas City-Missouri and Saint Luke's Mid America Heart Institute, Kansas City (J.A.S.).
Sarwat I ChaudhryFrom Section of Cardiovascular Medicine, Department of Internal Medicine (E.S.S., J.P.C., A.J.L., J.F.L., R.P.D., K.M., H.M.K.), Section of General Internal Medicine, Department of Internal Medicine (C.P.G., S.I.C.), Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine (L.A.C., C.P.G., H.M.K.), Yale Cardiovascular Research Group, Department of Internal Medicine (A.J.L.), and Department of Emergency Medicine (G.D., B.S.), Yale School of Medicine, New Haven, CT; Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, CT (E.S.S., S.Z., K.M.S., J.P.C., J.A.S.B.-F., J.F.L., H.B., R.P.D., K.M., H.M.K.); Department of Health Policy and Management, Yale School of Public Health, New Haven, CT (L.A.C., H.M.K.); Division of Cardiology, University of Colorado Anschutz Medical Campus, Aurora (F.A.M.); Division of Cardiology, Federal University of Sergipe, and the Clínica e Hospital São Lucas, Aracaju, Brazil (J.A.S.B.-F.); Department of Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain (H.B.); and University of Kansas City-Missouri and Saint Luke's Mid America Heart Institute, Kansas City (J.A.S.).
Gail D'OnofrioFrom Section of Cardiovascular Medicine, Department of Internal Medicine (E.S.S., J.P.C., A.J.L., J.F.L., R.P.D., K.M., H.M.K.), Section of General Internal Medicine, Department of Internal Medicine (C.P.G., S.I.C.), Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine (L.A.C., C.P.G., H.M.K.), Yale Cardiovascular Research Group, Department of Internal Medicine (A.J.L.), and Department of Emergency Medicine (G.D., B.S.), Yale School of Medicine, New Haven, CT; Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, CT (E.S.S., S.Z., K.M.S., J.P.C., J.A.S.B.-F., J.F.L., H.B., R.P.D., K.M., H.M.K.); Department of Health Policy and Management, Yale School of Public Health, New Haven, CT (L.A.C., H.M.K.); Division of Cardiology, University of Colorado Anschutz Medical Campus, Aurora (F.A.M.); Division of Cardiology, Federal University of Sergipe, and the Clínica e Hospital São Lucas, Aracaju, Brazil (J.A.S.B.-F.); Department of Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain (H.B.); and University of Kansas City-Missouri and Saint Luke's Mid America Heart Institute, Kansas City (J.A.S.).
Basmah SafdarFrom Section of Cardiovascular Medicine, Department of Internal Medicine (E.S.S., J.P.C., A.J.L., J.F.L., R.P.D., K.M., H.M.K.), Section of General Internal Medicine, Department of Internal Medicine (C.P.G., S.I.C.), Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine (L.A.C., C.P.G., H.M.K.), Yale Cardiovascular Research Group, Department of Internal Medicine (A.J.L.), and Department of Emergency Medicine (G.D., B.S.), Yale School of Medicine, New Haven, CT; Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, CT (E.S.S., S.Z., K.M.S., J.P.C., J.A.S.B.-F., J.F.L., H.B., R.P.D., K.M., H.M.K.); Department of Health Policy and Management, Yale School of Public Health, New Haven, CT (L.A.C., H.M.K.); Division of Cardiology, University of Colorado Anschutz Medical Campus, Aurora (F.A.M.); Division of Cardiology, Federal University of Sergipe, and the Clínica e Hospital São Lucas, Aracaju, Brazil (J.A.S.B.-F.); Department of Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain (H.B.); and University of Kansas City-Missouri and Saint Luke's Mid America Heart Institute, Kansas City (J.A.S.).
Rachel P DreyerFrom Section of Cardiovascular Medicine, Department of Internal Medicine (E.S.S., J.P.C., A.J.L., J.F.L., R.P.D., K.M., H.M.K.), Section of General Internal Medicine, Department of Internal Medicine (C.P.G., S.I.C.), Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine (L.A.C., C.P.G., H.M.K.), Yale Cardiovascular Research Group, Department of Internal Medicine (A.J.L.), and Department of Emergency Medicine (G.D., B.S.), Yale School of Medicine, New Haven, CT; Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, CT (E.S.S., S.Z., K.M.S., J.P.C., J.A.S.B.-F., J.F.L., H.B., R.P.D., K.M., H.M.K.); Department of Health Policy and Management, Yale School of Public Health, New Haven, CT (L.A.C., H.M.K.); Division of Cardiology, University of Colorado Anschutz Medical Campus, Aurora (F.A.M.); Division of Cardiology, Federal University of Sergipe, and the Clínica e Hospital São Lucas, Aracaju, Brazil (J.A.S.B.-F.); Department of Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain (H.B.); and University of Kansas City-Missouri and Saint Luke's Mid America Heart Institute, Kansas City (J.A.S.).
Karthik MurugiahFrom Section of Cardiovascular Medicine, Department of Internal Medicine (E.S.S., J.P.C., A.J.L., J.F.L., R.P.D., K.M., H.M.K.), Section of General Internal Medicine, Department of Internal Medicine (C.P.G., S.I.C.), Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine (L.A.C., C.P.G., H.M.K.), Yale Cardiovascular Research Group, Department of Internal Medicine (A.J.L.), and Department of Emergency Medicine (G.D., B.S.), Yale School of Medicine, New Haven, CT; Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, CT (E.S.S., S.Z., K.M.S., J.P.C., J.A.S.B.-F., J.F.L., H.B., R.P.D., K.M., H.M.K.); Department of Health Policy and Management, Yale School of Public Health, New Haven, CT (L.A.C., H.M.K.); Division of Cardiology, University of Colorado Anschutz Medical Campus, Aurora (F.A.M.); Division of Cardiology, Federal University of Sergipe, and the Clínica e Hospital São Lucas, Aracaju, Brazil (J.A.S.B.-F.); Department of Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain (H.B.); and University of Kansas City-Missouri and Saint Luke's Mid America Heart Institute, Kansas City (J.A.S.).
John A SpertusFrom Section of Cardiovascular Medicine, Department of Internal Medicine (E.S.S., J.P.C., A.J.L., J.F.L., R.P.D., K.M., H.M.K.), Section of General Internal Medicine, Department of Internal Medicine (C.P.G., S.I.C.), Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine (L.A.C., C.P.G., H.M.K.), Yale Cardiovascular Research Group, Department of Internal Medicine (A.J.L.), and Department of Emergency Medicine (G.D., B.S.), Yale School of Medicine, New Haven, CT; Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, CT (E.S.S., S.Z., K.M.S., J.P.C., J.A.S.B.-F., J.F.L., H.B., R.P.D., K.M., H.M.K.); Department of Health Policy and Management, Yale School of Public Health, New Haven, CT (L.A.C., H.M.K.); Division of Cardiology, University of Colorado Anschutz Medical Campus, Aurora (F.A.M.); Division of Cardiology, Federal University of Sergipe, and the Clínica e Hospital São Lucas, Aracaju, Brazil (J.A.S.B.-F.); Department of Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain (H.B.); and University of Kansas City-Missouri and Saint Luke's Mid America Heart Institute, Kansas City (J.A.S.).
Harlan M KrumholzFrom Section of Cardiovascular Medicine, Department of Internal Medicine (E.S.S., J.P.C., A.J.L., J.F.L., R.P.D., K.M., H.M.K.), Section of General Internal Medicine, Department of Internal Medicine (C.P.G., S.I.C.), Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine (L.A.C., C.P.G., H.M.K.), Yale Cardiovascular Research Group, Department of Internal Medicine (A.J.L.), and Department of Emergency Medicine (G.D., B.S.), Yale School of Medicine, New Haven, CT; Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, CT (E.S.S., S.Z., K.M.S., J.P.C., J.A.S.B.-F., J.F.L., H.B., R.P.D., K.M., H.M.K.); Department of Health Policy and Management, Yale School of Public Health, New Haven, CT (L.A.C., H.M.K.); Division of Cardiology, University of Colorado Anschutz Medical Campus, Aurora (F.A.M.); Division of Cardiology, Federal University of Sergipe, and the Clínica e Hospital São Lucas, Aracaju, Brazil (J.A.S.B.-F.); Department of Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain (H.B.); and University of Kansas City-Missouri and Saint Luke's Mid America Heart Institute, Kansas City (J.A.S.). harlan.krumholz@yale.edu.
Funding
Young Women With Acute Myocardial InfarctionR01HL081153 · NHLBI · YALE UNIVERSITY · PI KRUMHOLZ, HARLAN MARC · 2007 to 2012
$10.6MCenter for Cardiovascular Outcomes Research at Yale UniversityU01HL105270 · NHLBI · YALE UNIVERSITY · PI CURTIS, JEPTHA PELHAM, KRUMHOLZ, HARLAN MARC · 2010 to 2013
$5.8MYale-CORE Career Development Program in Patient-Centered Outcomes ResearchK12HS023000 · AHRQ · YALE UNIVERSITY · PI KRUMHOLZ, HARLAN MARC · 2014 to 2018
$3.4MAHRQ HHS K12 HS023000NHLBI NIH HHS R01 HL081153NHLBI NIH HHS U01 HL105270NHLBI NIH HHS U01 HL105270-05
Abstract
backgroundCurrent classification schemes for acute myocardial infarction (AMI) may not accommodate the breadth of clinical phenotypes in young women. METHODS AND
resultsWe developed a novel taxonomy among young adults (≤55 years) with AMI enrolled in the Variation in Recovery: Role of Gender on Outcomes of Young AMI Patients (VIRGO) study. We first classified a subset of patients (n=600) according to the Third Universal Definition of MI using a structured abstraction tool. There was heterogeneity within type 2 AMI, and 54 patients (9%; including 51 of 412 women) were unclassified. Using an inductive approach, we iteratively grouped patients with shared clinical characteristics, with the aims of developing a more inclusive taxonomy that could distinguish unique clinical phenotypes. The final VIRGO taxonomy classified 2802 study participants as follows: class 1, plaque-mediated culprit lesion (82.5% of women; 94.9% of men); class 2, obstructive coronary artery disease with supply-demand mismatch (2a: 1.4% women; 0.9% men) and without supply-demand mismatch (2b: 2.4% women; 1.1% men); class 3, nonobstructive coronary artery disease with supply-demand mismatch (3a: 4.3% women; 0.8% men) and without supply-demand mismatch (3b: 7.0% women; 1.9% men); class 4, other identifiable mechanism (spontaneous dissection, vasospasm, embolism; 1.5% women, 0.2% men); and class 5, undetermined classification (0.8% women, 0.2% men).
conclusionsApproximately 1 in 8 young women with AMI is unclassified by the Universal Definition of MI. We propose a more inclusive taxonomy that could serve as a framework for understanding biological disease mechanisms, therapeutic efficacy, and prognosis in this population.
Indexed as
Sex FactorsAdolescentAdultAge of OnsetAlgorithmsAortic DissectionClassificationCoronary DiseaseDiagnostic Techniques, CardiovascularFemaleHumansMaleMedical RecordsMiddle AgedMyocardial InfarctionMyocardiumclassificationmyocardial infarctionsex characteristics
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.