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OMI – nytt begrepp för infarkt på grund av akut kranskärlsocklusion

Lindow, Thomas LU ; Pahlm, Olle LU ; Mokhtari, Arash LU ; Koul, Sasha LU ; Hammarlund, Peter and Ekelund, Ulf LU orcid (2025) In Lakartidningen 122.
Abstract

The classification of acute myocardial infarction (AMI) based on ECG changes has evolved over time. Before the revascularization era, AMI was classified based on Q-waves that indicate loss of myocardium. After thrombolysis trials in the 1990s demonstrated a survival benefit, ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI) classifications were introduced to guide immediate reperfusion therapy with thrombolysis or percutaneous coronary intervention. However, STEMI criteria have limitations. ST elevation is not synonymous with acute coronary occlusion and can occur in pericarditis, early repolarization, left ventricular hypertrophy and other disorders. The process of occlusion... (More)

The classification of acute myocardial infarction (AMI) based on ECG changes has evolved over time. Before the revascularization era, AMI was classified based on Q-waves that indicate loss of myocardium. After thrombolysis trials in the 1990s demonstrated a survival benefit, ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI) classifications were introduced to guide immediate reperfusion therapy with thrombolysis or percutaneous coronary intervention. However, STEMI criteria have limitations. ST elevation is not synonymous with acute coronary occlusion and can occur in pericarditis, early repolarization, left ventricular hypertrophy and other disorders. The process of occlusion is dynamic, and temporary thrombus resolution may cause ST elevation to be absent at the time of ECG recording. Furthermore, ST elevation depends on vector orientation; posterior infarcts may only show ST depression. Studies show that many NSTEMI cases are caused by acute occlusions, which are associated with worse prognosis. The sensitivity of current STEMI criteria is low, and several ECG findings suggestive of acute coronary occlusion have been described. A new classification, »Occlusion Myocardial Infarction« (OMI), has been proposed to improve detection and guide intervention beyond strict STEMI criteria.

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author
; ; ; ; and
organization
alternative title
»Occlusion Myocardial Infarction« (OMI) - a new classification proposed to improve detection beyond strict STEMI criteria
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Humans, Coronary Occlusion/diagnosis, Electrocardiography, Myocardial Infarction/classification, Non-ST Elevated Myocardial Infarction/diagnosis, ST Elevation Myocardial Infarction/diagnosis
in
Lakartidningen
volume
122
publisher
Swedish Medical Association
external identifiers
  • pmid:40421749
ISSN
0023-7205
language
Swedish
LU publication?
yes
id
91ded53b-bb6b-4766-a737-7532f6977266
alternative location
https://lakartidningen.se/vetenskap/omi-nytt-begrepp-for-infarkt-pa-grund-av-akut-kranskarlsocklusion/
date added to LUP
2026-06-09 14:09:56
date last changed
2026-06-09 15:39:49
@article{91ded53b-bb6b-4766-a737-7532f6977266,
  abstract     = {{<p>The classification of acute myocardial infarction (AMI) based on ECG changes has evolved over time. Before the revascularization era, AMI was classified based on Q-waves that indicate loss of myocardium. After thrombolysis trials in the 1990s demonstrated a survival benefit, ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI) classifications were introduced to guide immediate reperfusion therapy with thrombolysis or percutaneous coronary intervention. However, STEMI criteria have limitations. ST elevation is not synonymous with acute coronary occlusion and can occur in pericarditis, early repolarization, left ventricular hypertrophy and other disorders. The process of occlusion is dynamic, and temporary thrombus resolution may cause ST elevation to be absent at the time of ECG recording. Furthermore, ST elevation depends on vector orientation; posterior infarcts may only show ST depression. Studies show that many NSTEMI cases are caused by acute occlusions, which are associated with worse prognosis. The sensitivity of current STEMI criteria is low, and several ECG findings suggestive of acute coronary occlusion have been described. A new classification, »Occlusion Myocardial Infarction« (OMI), has been proposed to improve detection and guide intervention beyond strict STEMI criteria.</p>}},
  author       = {{Lindow, Thomas and Pahlm, Olle and Mokhtari, Arash and Koul, Sasha and Hammarlund, Peter and Ekelund, Ulf}},
  issn         = {{0023-7205}},
  keywords     = {{Humans; Coronary Occlusion/diagnosis; Electrocardiography; Myocardial Infarction/classification; Non-ST Elevated Myocardial Infarction/diagnosis; ST Elevation Myocardial Infarction/diagnosis}},
  language     = {{swe}},
  month        = {{05}},
  publisher    = {{Swedish Medical Association}},
  series       = {{Lakartidningen}},
  title        = {{OMI – nytt begrepp för infarkt på grund av akut kranskärlsocklusion}},
  url          = {{https://lakartidningen.se/vetenskap/omi-nytt-begrepp-for-infarkt-pa-grund-av-akut-kranskarlsocklusion/}},
  volume       = {{122}},
  year         = {{2025}},
}