g., CK-MB, troponin) is reasonable in the first 24 hours after CABG, and cTn is preferred to CK-MB as the optimal indicator of myonecrosis.13 Additional Considerations The 2012 task force included new sections pertinent to myocardial injury and MI in patients undergoing cardiac and non-cardiac procedures, in critically-ill patients, and in patients with heart failure.2 These sections

emphasized the risk of myocardial necrosis due to regional ischemia or direct trauma in certain cardiovascular procedures, including transcatheter aortic valve replacement (TAVR) or mitral clip. In the absence of supporting evidence, the task force recommended using the same criteria for an MI diagnosis in patients undergoing TAVR. Inhibitors,research,lifescience,medical Caution is advised against mislabeling myocardial necrosis Inhibitors,research,lifescience,medical associated with the ablation of arrhythmias as MI. In accordance with the 2008-2009 revision of the WHO definition of MI,14 the third global MI task force also differentiated between recurrent MI and reinfarction.2 Reinfarction describes an acute MI occurring within 28

days of an incident or recurrent MI. The Inhibitors,research,lifescience,medical 2012 task force did not recommend CK-MB measurements in these patients but, rather, serial cTn measurements, with the reinfarction diagnosis established when a ≥20% increase in cTn values is observed. If characteristics of MI occur after 28 days following an incident MI, it is considered to be a recurrent MI. The 2012 task force also recommends the routine monitoring of cardiac biomarkers in high-risk patients both prior to and 48–72 hours after major noncardiac surgery, but it

does not define high-risk surgical procedures.2 In general, major vascular surgery (aortic/peripheral vascular surgery with reported perioperative cardiac risk >5%) is considered a high- risk or Inhibitors,research,lifescience,medical major surgery.15 Conclusion In summary, the Third Universal Definition of Myocardial Infarction consensus document incorporates patient symptoms, ECG changes, the highly sensitive cTn biochemical markers, and information gleaned from various imaging techniques into comprehensive, Inhibitors,research,lifescience,medical clinically oriented, and reproducible definitions of MI. Funding Statement Funding/Support: Dr Bozkurt receives grant funding from the National Institutes of Health and from Forest Pharmaceuticals. Footnotes Conflict of Interest Disclosure: The authors have completed and submitted the Methodist DeBakey Cardiovascular Journal Conflict GPX6 of Interest Statement and none were reported.
Introduction There are growing numbers of adults with congenital heart disease (CHD), and the role of cardiac LBH589 in vitro magnetic resonance (CMR) imaging is continually expanding in this patient population.1 The majority of these patients have undergone surgical repairs in childhood, and lifelong follow-up is recommended.2 Serial imaging of adults with CHD is important to monitor for interval changes, as many adults with CHD do not recognize subtle changes in exercise capacity.