Myocardial infarction (MI) data elements
| Variable . | Level 1 (basic) . | Level 2 (intermediate) . | Level 3 (comprehensive) . |
|---|---|---|---|
| Date of acute MI | Date acute MI diagnosed: DD/MM/YYYY | Date acute MI diagnosed: DD/MM/YYYY | Date acute MI diagnosed: DD/MM/YYYY |
| Antithrombotic therapy at time of MI | Antithrombotic therapy form | Antithrombotic therapy form | Antithrombotic therapy form |
| Type of acute MI | Select one: ☐ Type 1: spontaneous ☐ Type 2: ischemic imbalance ☐ Type 3: death, no biomarkers ☐ Type 4a: percutaneous coronary intervention related ☐ Type 4b: stent thrombosis ☐ Type 5: coronary artery bypass grafting related ☐ Unknown | ||
| Cardiovascular risk factors | Select all that apply: ☐ Known cardiovascular disease (coronary artery disease, peripheral arterial disease, cerebrovascular disease) ☐ Hypertension ☐ Diabetes mellitus ☐ Current smoker ☐ Former smoker ☐ Hypercholesterolemia ☐ Obesity | Select all that apply: ☐ Known cardiovascular disease (coronary artery disease, peripheral arterial disease, cerebrovascular disease) ☐ Hypertension ☐ Diabetes mellitus ☐ Current smoker ☐ Former smoker ☐ Hypercholesterolemia ☐ Obesity | Select all that apply: ☐ Known cardiovascular disease (coronary artery disease, peripheral arterial disease, cerebrovascular disease) ☐ Hypertension ☐ Diabetes mellitus ☐ Current smoker ☐ Former smoker ☐ Hypercholesterolemia ☐ Obesity |
| Symptoms of acute MI | Presence of symptoms of myocardial ischemia: ☐ No ☐ Yes ☐ Unknown | Presence of symptoms of myocardial ischemia: ☐ No ☐ Yes ☐ Unknown | Presence of symptoms of myocardial ischemia: ☐ No ☐ Yes ☐ Unknown |
| Acute ischemic ECG changes | Presence of new or presumed new ischemic ECG changes ☐ No ☐ Yes ☐ Unknown | Presence of new or presumed new ischemic ECG changes ☐ No ☐ Yes ☐ Ischemic changes on ECG ☐ Left bundle branch block ☐ Unknown | Presence of new or presumed new ischemic ECG changes ☐ No ☐ Yes ☐ Ischemic changes on ECG ☐ Left bundle branch block ☐ Unknown |
| New Q waves on ECG | Presence of new Q waves: ☐ No ☐ Yes ☐ Unknown | Presence of new Q waves: ☐ No ☐ Yes ☐ Unknown | Presence of new Q waves: ☐ No ☐ Yes ☐ Unknown |
| Change in noninvasive imaging | Change in noninvasive imaging ☐ No ☐ Yes ☐ Unknown | Change in noninvasive imaging ☐ No ☐ Yes ☐ New loss of viable myocardium ☐ New regional wall motion abnormality ☐ Unknown | Change in noninvasive imaging ☐ No ☐ Yes ☐ New loss of viable myocardium ☐ New regional wall motion abnormality ☐ Unknown |
| Cardiac biomarker | Cardiac biomarker >99% upper reference limit ☐ No ☐ Yes ☐ Unknown | Cardiac biomarker >99% upper reference limit ☐ No ☐ Yes, specify biomarker: ______________ ☐ Unknown | Cardiac biomarker >99% upper reference limit ☐ No ☐ Yes, specify biomarker: ___________________ ☐ Unknown |
| Reperfusion treatment | Did the patient undergo reperfusion treatment of this MI: ☐ No (medical management) ☐ Yes ☐ Unknown | Did the patient undergo reperfusion treatment of this MI: ☐ No (medical management) ☐ Yes (select all that apply): ☐ Percutaneous coronary intervention ☐ Coronary artery bypass grafting ☐ Systemic thrombolytic therapy ☐ Other (specify): ____________ ☐ Unknown | Did the patient undergo reperfusion treatment of this MI: ☐ No (medical management) ☐ Yes (select all that apply): ☐ Percutaneous coronary intervention ☐ Coronary artery bypass grafting ☐ Systemic thrombolytic therapy ☐ Other (specify): ____________ ☐ Unknown |
| Antithrombotic treatment of MI | Antithrombotic therapy form |
| Variable . | Level 1 (basic) . | Level 2 (intermediate) . | Level 3 (comprehensive) . |
|---|---|---|---|
| Date of acute MI | Date acute MI diagnosed: DD/MM/YYYY | Date acute MI diagnosed: DD/MM/YYYY | Date acute MI diagnosed: DD/MM/YYYY |
| Antithrombotic therapy at time of MI | Antithrombotic therapy form | Antithrombotic therapy form | Antithrombotic therapy form |
| Type of acute MI | Select one: ☐ Type 1: spontaneous ☐ Type 2: ischemic imbalance ☐ Type 3: death, no biomarkers ☐ Type 4a: percutaneous coronary intervention related ☐ Type 4b: stent thrombosis ☐ Type 5: coronary artery bypass grafting related ☐ Unknown | ||
| Cardiovascular risk factors | Select all that apply: ☐ Known cardiovascular disease (coronary artery disease, peripheral arterial disease, cerebrovascular disease) ☐ Hypertension ☐ Diabetes mellitus ☐ Current smoker ☐ Former smoker ☐ Hypercholesterolemia ☐ Obesity | Select all that apply: ☐ Known cardiovascular disease (coronary artery disease, peripheral arterial disease, cerebrovascular disease) ☐ Hypertension ☐ Diabetes mellitus ☐ Current smoker ☐ Former smoker ☐ Hypercholesterolemia ☐ Obesity | Select all that apply: ☐ Known cardiovascular disease (coronary artery disease, peripheral arterial disease, cerebrovascular disease) ☐ Hypertension ☐ Diabetes mellitus ☐ Current smoker ☐ Former smoker ☐ Hypercholesterolemia ☐ Obesity |
| Symptoms of acute MI | Presence of symptoms of myocardial ischemia: ☐ No ☐ Yes ☐ Unknown | Presence of symptoms of myocardial ischemia: ☐ No ☐ Yes ☐ Unknown | Presence of symptoms of myocardial ischemia: ☐ No ☐ Yes ☐ Unknown |
| Acute ischemic ECG changes | Presence of new or presumed new ischemic ECG changes ☐ No ☐ Yes ☐ Unknown | Presence of new or presumed new ischemic ECG changes ☐ No ☐ Yes ☐ Ischemic changes on ECG ☐ Left bundle branch block ☐ Unknown | Presence of new or presumed new ischemic ECG changes ☐ No ☐ Yes ☐ Ischemic changes on ECG ☐ Left bundle branch block ☐ Unknown |
| New Q waves on ECG | Presence of new Q waves: ☐ No ☐ Yes ☐ Unknown | Presence of new Q waves: ☐ No ☐ Yes ☐ Unknown | Presence of new Q waves: ☐ No ☐ Yes ☐ Unknown |
| Change in noninvasive imaging | Change in noninvasive imaging ☐ No ☐ Yes ☐ Unknown | Change in noninvasive imaging ☐ No ☐ Yes ☐ New loss of viable myocardium ☐ New regional wall motion abnormality ☐ Unknown | Change in noninvasive imaging ☐ No ☐ Yes ☐ New loss of viable myocardium ☐ New regional wall motion abnormality ☐ Unknown |
| Cardiac biomarker | Cardiac biomarker >99% upper reference limit ☐ No ☐ Yes ☐ Unknown | Cardiac biomarker >99% upper reference limit ☐ No ☐ Yes, specify biomarker: ______________ ☐ Unknown | Cardiac biomarker >99% upper reference limit ☐ No ☐ Yes, specify biomarker: ___________________ ☐ Unknown |
| Reperfusion treatment | Did the patient undergo reperfusion treatment of this MI: ☐ No (medical management) ☐ Yes ☐ Unknown | Did the patient undergo reperfusion treatment of this MI: ☐ No (medical management) ☐ Yes (select all that apply): ☐ Percutaneous coronary intervention ☐ Coronary artery bypass grafting ☐ Systemic thrombolytic therapy ☐ Other (specify): ____________ ☐ Unknown | Did the patient undergo reperfusion treatment of this MI: ☐ No (medical management) ☐ Yes (select all that apply): ☐ Percutaneous coronary intervention ☐ Coronary artery bypass grafting ☐ Systemic thrombolytic therapy ☐ Other (specify): ____________ ☐ Unknown |
| Antithrombotic treatment of MI | Antithrombotic therapy form |
ECG, electrocardiogram.