Q-wave / Non-Q-wave Dichotomy
- 1941: Q-waves noted as a distinguishing feature of “acute coronary occlusion” compared to “acute coronary insufficiency with infarction”
- Master, Arthur M., et al. “Differentiation of acute coronary insufficiency with myocardial infarction from coronary occlusion.” Archives of Internal Medicine 67.3 (1941): 647-657.
- Master, Arthur M., et al. “Differentiation of acute coronary insufficiency with myocardial infarction from coronary occlusion.” Archives of Internal Medicine 67.3 (1941): 647-657.
- 1980: The terms “Q-wave” and “Non-Q-wave” infarctions were reportedly first coined
- PMID 8421361: Spodick, David H. “Q-Wave vs NonβQ-Wave Infarction: An Oversimplified Dichotomy.” JAMA 269.5 (1993): 590-590.
- “The terms ‘Q-wave’ and ‘non-Q-wave’ infarctions were first coined in a letter by respected cardiologists. Unfortunately, this terminology, probably due to its distinguished provenance, was rapidly taken up by clinicians and investigators.”
- “The terms ‘Q-wave’ and ‘non-Q-wave’ infarctions were first coined in a letter by respected cardiologists. Unfortunately, this terminology, probably due to its distinguished provenance, was rapidly taken up by clinicians and investigators.”
- PMID 8421361: Spodick, David H. “Q-Wave vs NonβQ-Wave Infarction: An Oversimplified Dichotomy.” JAMA 269.5 (1993): 590-590.
- 1983: Q-wave vs Non-Q-wave recognized as an oversimplified dichotomy
- PMID 6829457: Spodick, David H. “Q-wave infarction versus ST infarction. Nonspecificity of electrocardiographic criteria for differentiating transmural and nontransmural lesions.” Am J Cardiol 51 (1983): 913-915.
- “Whatever the reason for continued confusion regarding their anatomic extent, the pseudospecificty of Q and S-T myocardial infarctions remains a lasting myth … False terminology does more than semantic damage: it does conceptual damage. If we continue to accept a Q infarct as dependably indicating a transmural lesion, we can inhibit consideration of what it really does mean … Given the ultimate nonspecificity of many electrocardiographic findings it should not be surprising that they overlap to such a a degree that “transmural” and “nontransmural” are gross misnomers.”
- “Whatever the reason for continued confusion regarding their anatomic extent, the pseudospecificty of Q and S-T myocardial infarctions remains a lasting myth … False terminology does more than semantic damage: it does conceptual damage. If we continue to accept a Q infarct as dependably indicating a transmural lesion, we can inhibit consideration of what it really does mean … Given the ultimate nonspecificity of many electrocardiographic findings it should not be surprising that they overlap to such a a degree that “transmural” and “nontransmural” are gross misnomers.”
- PMID 6829457: Spodick, David H. “Q-wave infarction versus ST infarction. Nonspecificity of electrocardiographic criteria for differentiating transmural and nontransmural lesions.” Am J Cardiol 51 (1983): 913-915.
- 1988: Q-Wave vs Non-Q-Wave recognized as an oversimplified dichotomy
- PMID: 3414524: Spodick, David H. “Comprehensive electrocardiographic analysis of acute myocardial infarction by individual and combined waveforms.” The American Journal of Cardiology 62.7 (1988): 465-467.
- “The ‘Q’ versus ‘non-Q’ dichotomy is inadequate for clinicopatholologic and prognostic electrocardiographic classification of acute myocardial infarction. All individual and appropriate combinations of waveforms, their distributions and temporal behavior must be characterized with due regard for the many confounding factors outlined”
- “The ‘Q’ versus ‘non-Q’ dichotomy is inadequate for clinicopatholologic and prognostic electrocardiographic classification of acute myocardial infarction. All individual and appropriate combinations of waveforms, their distributions and temporal behavior must be characterized with due regard for the many confounding factors outlined”
- PMID: 3414524: Spodick, David H. “Comprehensive electrocardiographic analysis of acute myocardial infarction by individual and combined waveforms.” The American Journal of Cardiology 62.7 (1988): 465-467.
- 1992: Q-Wave vs Non-Q-Wave recognized as an oversimplified dichotomy
- PMID 1518115: Moss, Arthur J. “Q-Wave vs NonβQ-Wave Myocardial Infarction: An Oversimplified Dichotomy.” JAMA 268.12 (1992): 1595-1596.
- “The Q-wave vs non-Q-wave categorization does not provide sufficiently sensitivity, specificity, or predictive accuracy about the subsequent clinical course of patients with a first myocardial infarction to use it as reliable data in the clinical decision making process.”
- PMID 1518115: Moss, Arthur J. “Q-Wave vs NonβQ-Wave Myocardial Infarction: An Oversimplified Dichotomy.” JAMA 268.12 (1992): 1595-1596.
STEMI / NSTEMI Dichotomy
Evolution of STEMI criteria:
- 1994: 1mm in all leads – STEMI “millimeter criteria” are born
- PMID 7905143: FTT meta-analysis
- PMID 7905143: FTT meta-analysis
- 2000: Increased to 2mm in V1-V3
- PMID 10987628: π 1st Universal Definition of MI
- PMID 11781962: Macfarlane: Age, Sex, ST Segments
- 2004: Back to 1mm everywhere
- PMID 15358045: π ACC/AHA STEMI Guidelines
- PMID 15534817: Macfarlane 20204
- 2007: V2 and V2 now have β / β difference
- PMID 18036459: π 2nd Universal Definition of MI
- PMID 18036459: π 2nd Universal Definition of MI
- 2009: V2 and V3 now have β / β and age difference
- PMID 01928193: π AHA/ACCF/HRS Standardization and Interpretation of Electrocardiogram (Wagner and Macfarlane)
- PMID 01928193: π AHA/ACCF/HRS Standardization and Interpretation of Electrocardiogram (Wagner and Macfarlane)
- 2012: No changes to STEMI criteria
- PMID 22958960: π 3rd Universal Definition of MI
- PMID 22958960: π 3rd Universal Definition of MI
- 2018: No changes to STEMI criteria
- PMID 30571511: π 4th Universal Definition of MI
- Introduce guidance on points from which to measure ST segment
OMI / NOMI Dichotomy
- 2014: “The False STEMI – NonSTEMI Dichotomy” term is coined
- Dr. Smith begins lecturing on “The False STEMI – NonSTEMI Dichotomy“
- SMACC 2014 Video Recording
- 2018: “OMI / NOMI” term coined via Twitter poll
- 2018: “The OMI Manifestos” is published
- 2019: Prospective, real-world evidence showing the gap between ST elevation myocardial infarction (STEMI) and occlusion MI (OMI)
- PMID 31331673: Meyers, H. Pendell, and Stephen W. Smith. “Prospective, real-world evidence showing the gap between ST elevation myocardial infarction (STEMI) and occlusion MI (OMI).” International Journal of Cardiology 293 (2019): 48-49.
- PMID 31331673: Meyers, H. Pendell, and Stephen W. Smith. “Prospective, real-world evidence showing the gap between ST elevation myocardial infarction (STEMI) and occlusion MI (OMI).” International Journal of Cardiology 293 (2019): 48-49.
- 2021: STEMI(-) OMI patients noted with significant delays to catheterization but adverse outcomes more similar to STEMI(+) OMI than those with no occlusion.
- PMID 33308915: Meyers, H. Pendell, et al. “Comparison of the ST-elevation myocardial infarction (STEMI) vs. NSTEMI and occlusion MI (OMI) vs. NOMI paradigms of acute MI.” The Journal of emergency medicine 60.3 (2021): 273-284.
- PMID 33308915: Meyers, H. Pendell, et al. “Comparison of the ST-elevation myocardial infarction (STEMI) vs. NSTEMI and occlusion MI (OMI) vs. NOMI paradigms of acute MI.” The Journal of emergency medicine 60.3 (2021): 273-284.
- 2021: Blinded interpretation using predefined OMI ECG findings found to be superior to STEMI criteria for the ECG diagnosis of Occlusion MI
- PMID 33912650: Meyers, H. Pendell, et al. “Accuracy of OMI ECG findings versus STEMI criteria for diagnosis of acute coronary occlusion myocardial infarction.” IJC Heart & Vasculature 33 (2021): 100767.
- PMID 33912650: Meyers, H. Pendell, et al. “Accuracy of OMI ECG findings versus STEMI criteria for diagnosis of acute coronary occlusion myocardial infarction.” IJC Heart & Vasculature 33 (2021): 100767.
- 2021: Step-by-step approach to OMI diagnosis proposed by Drs. Aslanger, Meyers and Smith
- PMID 34523597: Aslanger, Emre K., H. Pendell Meyers, and Stephen W. Smith. “Recognizing electrocardiographically subtle occlusion myocardial infarction and differentiating it from mimics: Ten steps to or away from cath lab.” Turk Kardiyoloji Dernegi Arsivi 49.6 (2021): 488.
- PMID 34523597: Aslanger, Emre K., H. Pendell Meyers, and Stephen W. Smith. “Recognizing electrocardiographically subtle occlusion myocardial infarction and differentiating it from mimics: Ten steps to or away from cath lab.” Turk Kardiyoloji Dernegi Arsivi 49.6 (2021): 488.
- 2022: The ACC endorses the following “STEMI Equivalents”: 1) LBBB or VP-rhythm with Sgarbossa or Smith-modified Sgarbossa Criteria; 2) Hyperacute T Waves; 3) Posterior STEMI; 4) De Winter Sign
- PMID 36241466: π Writing Committee, et al. “2022 ACC expert consensus decision pathway on the evaluation and disposition of acute chest pain in the emergency department: a report of the American College of Cardiology solution set oversight committee.” Journal of the American College of Cardiology 80.20 (2022): 1925-1960.
- PMID 36241466: π Writing Committee, et al. “2022 ACC expert consensus decision pathway on the evaluation and disposition of acute chest pain in the emergency department: a report of the American College of Cardiology solution set oversight committee.” Journal of the American College of Cardiology 80.20 (2022): 1925-1960.
- 2023:
- PMID 37061867: Zoni, Cesar R., Debabrata Mukherjee, and Martha Gulati. “Proposed new classification for acute coronary syndrome: Acute coronary syndrome requiring immediate reperfusion.” Catheterization and Cardiovascular Interventions (2023).
- PMID 37061867: Zoni, Cesar R., Debabrata Mukherjee, and Martha Gulati. “Proposed new classification for acute coronary syndrome: Acute coronary syndrome requiring immediate reperfusion.” Catheterization and Cardiovascular Interventions (2023).
- 2023: A machine learning model demonstrated superiority in detecting subtle ischemic ECG changes indicative of OMI in an observer-independent approach
- PMID 36778371: Al-Zaiti, Salah, et al. “Machine Learning for the ECG Diagnosis and Risk Stratification of Occlusion Myocardial Infarction at First Medical Contact.” (2023).
- PMID 36778371: Al-Zaiti, Salah, et al. “Machine Learning for the ECG Diagnosis and Risk Stratification of Occlusion Myocardial Infarction at First Medical Contact.” (2023).
- 2023: STEMI criteria found to miss the majority of OMI
- PMID 34967919: McLaren, Jesse TT, et al. “Missing occlusions: Quality gaps for ED patients with occlusion MI.” The American Journal of Emergency Medicine (2023).