Type 1

MI caused by atherothrombotic event precipitated by plaque erosion or plaque rupture with thrombus formation

Type 2

Ischemic myocardial injury, usually in the setting of coronary atherosclerosis, from oxygen supply-demand mismatch without plaque erosion or rupture (eg, sudden anemia, prolonged tachyarrhythmia, coronary artery spasm or dissection, shock)

Sudden cardiac death with new ischemic ECG changes or ventricular fibrillation with symptoms suggestive of myocardial ischemia; death occurs before blood biomarkers can be obtained or before increases in biomarkers are identified

Type 4a

PCI-related MI

Type 4b

In-stent thrombosis documented angiographically or by the same criteria as type 1 MI

Type 4c

In-stent restenosis or restenosis after balloon angioplasty documented angiographically or by the same criteria as type 1 MI

Type 5

CABG-related MI

a Rise and fall of cardiac troponins with ≥1 troponin value >99th percentile of URL along with either new ischemic ECG changes, development of pathologic Q waves, symptoms of acute myocardial ischemia, imaging evidence of new wall motion abnormality or loss of viable myocardium, or angiographic identification of coronary thrombus.

b Further specific criteria: Coronary procedure–related MI ≤48 hours after the index procedure with an elevation in cardiac troponin values >5 × >99th percentile of URL for type 4a MI, >10 × for type 5 MI in patients with normal values at baseline. Patients with elevated but stable or declining baseline values must meet the criterion of >5-fold (in type 4a) or >10-fold (in type 5) increase as well as have a change ≥20% from the baseline value. Patients must also have one of the following: new ischemic changes (type 4a MI only), new pathologic Q waves, imaging evidence of loss of viable myocardium, or angiographic findings of a procedure-related flow-limiting complication.