The Evolving Paradigm of Myocardial Infarction in the Era of Artificial Intelligence.

IF 1 4区 医学 Q3 MEDICINE, GENERAL & INTERNAL
British journal of hospital medicine Pub Date : 2025-02-25 Epub Date: 2025-02-23 DOI:10.12968/hmed.2024.0847
Maroua Dali, Cecilia Maria Elizabeth Bogle, Richard Gordon Bogle
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引用次数: 0

Abstract

The classification and treatment of myocardial infarction (MI) have evolved significantly over the past few decades, with the ST-segment elevation myocardial infarction (STEMI)/non-STEMI (NSTEMI) paradigm dominating clinical practice. While STEMI, identified by ST-segment elevation (STE) on electrocardiogram (ECG), has been the hallmark for urgent reperfusion therapy, this model misses a substantial number of patients with occlusive myocardial infarction (OMI) who do not exhibit STE. Recent evidence reveals that up to 25% of NSTEMI patients have OMI, leading to higher mortality due to delayed reperfusion. The emerging OMI/NOMI (Occlusive vs. Non-Occlusive MI) paradigm offers a more nuanced approach, incorporating advanced ECG interpretation and tools like point-of-care echocardiography and artificial intelligence (AI). AI has shown promise in detecting subtle ECG changes indicative of OMI, improving diagnostic accuracy and reducing misdiagnosis. This paradigm shift has important implications for clinical practice, calling for earlier identification of OMI and more inclusive treatment strategies to enhance patient outcomes.

人工智能时代心肌梗死的演化范式
在过去的几十年里,心肌梗死(MI)的分类和治疗发生了重大变化,st段抬高型心肌梗死(STEMI)/非STEMI (NSTEMI)模式主导了临床实践。虽然STEMI(通过心电图上st段抬高(STE)来识别)一直是紧急再灌注治疗的标志,但该模型忽略了大量不表现STE的闭塞性心肌梗死(OMI)患者。最近的证据显示,高达25%的NSTEMI患者有OMI,导致再灌注延迟导致更高的死亡率。新兴的OMI/NOMI(闭塞性与非闭塞性MI)范式提供了一种更细致入微的方法,结合了先进的ECG解释和工具,如即时超声心动图和人工智能(AI)。人工智能在检测指示OMI的细微心电图变化、提高诊断准确性和减少误诊方面显示出了希望。这种范式转变对临床实践具有重要意义,要求尽早识别OMI并采取更具包容性的治疗策略,以提高患者的预后。
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来源期刊
British journal of hospital medicine
British journal of hospital medicine 医学-医学:内科
CiteScore
1.50
自引率
0.00%
发文量
176
审稿时长
4-8 weeks
期刊介绍: British Journal of Hospital Medicine was established in 1966, and is still true to its origins: a monthly, peer-reviewed, multidisciplinary review journal for hospital doctors and doctors in training. The journal publishes an authoritative mix of clinical reviews, education and training updates, quality improvement projects and case reports, and book reviews from recognized leaders in the profession. The Core Training for Doctors section provides clinical information in an easily accessible format for doctors in training. British Journal of Hospital Medicine is an invaluable resource for hospital doctors at all stages of their career. The journal is indexed on Medline, CINAHL, the Sociedad Iberoamericana de Información Científica and Scopus.
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