• Giuseppe Lippi, Fabian Sanchis-Gomar, and Gianfranco Cervellin.
• Section of Clinical Biochemistry, University of Verona, Verona, Italy. Electronic address: giuseppe.lippi@univr.it.
• Int. J. Cardiol. 2016 Jul 15; 215: 20-2.

BackgroundSome studies investigated the leading demographic and clinical characteristics of patient with type 2 myocardial infarction (MI), but a comprehensive analysis between type 1 and 2 MI patients is lacking. Therefore, we reviewed current evidence about the difference in clinical signs and symptoms at presentation in patients with type 1 and 2 MI.Materials And MethodsWe conducted an electronic search in Medline (with PubMed interface), Scopus and ISI Web of Science using the keywords "Type(-)2" or "Type II" and "myocardial infarction" and "chest pain" and "dyspnea" in "Title/Abstract/Keywords", with no language restriction, date limited from year 2007 to present, and study cohorts including more than 400 overall cases of MI.ResultsOverall, 37 documents were identified, but 33 were excluded since thoughtful comparison between the frequency of chest pain, dyspnea and other symptoms between patients with type 1 and type 2 MI was unavailable. Therefore, 4 studies were finally selected for analysis. Despite significant heterogeneity, the frequency of chest pain was consistently higher in patients with type 1 than type 2 MI (85% vs. 61%; p<0.001), whereas that of dyspnea and other symptoms was approximately 60-70% lower in type 1 than in type 2 MI. The odds ratio of chest pain was 3.5 in type 1 compared to type 2 MI, whereas that of dyspnea and other symptoms was 0.27 and 0.39 in type 1 compared to type 2 MI, respectively.ConclusionOur literature analysis suggests that "atypical" presentation may be more frequent in type 2 than in type 1 MI.Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

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