DEFINing the PrEvalence and Characteristics of Coronary Artery Disease Among Patients With TYPE 2 Myocardial Infarction Using CT-FFR

Prior treatment

• Prior coronary artery bypass grafting
• Known prior left main coronary artery PCI
• Known prior PCI to 2 or more major coronary vessels (i.e. left anterior descending artery, left circumflex artery, right coronary artery)

Other illness

• Contrast allergy
• Pre-operative history of MI, coronary angiography or coronary revascularization for patients with post-operative type 2 MI
• Severe arrhythmias precluding optimal CT image acquisition
• Allergy or contraindication to nitroglycerin

Lab values

• eGFR \<30 ml/min/1.73m2

Other

• Other types of MI
• Hemodynamic instability
• Pregnant or breast-feeding women
• Known PCI of the left coronary system combined with \>30% stenosis in the left main artery

• Capable of giving informed consent
• Patients aged greater than18 years diagnosed with type 2 MI, defined based on the 4th Universal Definition of Myocardial Infarction (1), during their index hospitalization
• Type 2 MI will be defined as detection of a rise and/or fall of troponin levels with at least one value above the 99th percentile and evidence of an imbalance between myocardial oxygen supply and demand, requiring at least one of the following:
  • Symptoms of acute myocardial ischemia;
  • New ischemic ECG changes;
  • Development of pathological Q waves;
  • Imaging evidence of new loss of viable myocardium, or new regional wall motion abnormality in a pattern consistent with an ischemic etiology
• Patients with medical precipitants of their type 2 MI or post-operative type 2 MI. A minimum of 10 patients with post-operative type 2 MI will be included to ensure a diverse clinical patient population is enrolled.