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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">kpccz</journal-id><journal-title-group><journal-title xml:lang="ru">Комплексные проблемы сердечно-сосудистых заболеваний</journal-title><trans-title-group xml:lang="en"><trans-title>Complex Issues of Cardiovascular Diseases</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2306-1278</issn><issn pub-type="epub">2587-9537</issn><publisher><publisher-name>Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Diseases”</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.17802/2306-1278-2022-11-1-78-89</article-id><article-id custom-type="elpub" pub-id-type="custom">kpccz-1047</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>АНАЛИТИЧЕСКИЙ ОБЗОР. Кардиология</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>REVIEW. Cardiology</subject></subj-group></article-categories><title-group><article-title>Спорные вопросы ведения пациентов с инфарктом миокарда второго типа</article-title><trans-title-group xml:lang="en"><trans-title>Controversial issues of type 2 myocardial infarction patients management</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-0209-4878</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Кинаш</surname><given-names>В. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Kinash</surname><given-names>V. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Кинаш Владимир Иванович - врач - рентгенэндоваскулярный хирург бюджетного учреждения Ханты-Мансийского автономного округа - Югры «Окружной кардиологический диспансер «Центр диагностики и сердечно-сосудистой хирургии»; аспирант кафедры кардиологии медицинского института бюджетного учреждения высшего образования Ханты-Мансийского автономного округа - Югры «Сургутский государственный университет».</p><p>просп. Ленина, 69/1, Ханты-Мансийский автономный округ - Югра, Сургут, 628416.</p></bio><bio xml:lang="en"><p>Vladimir I. Kinash - X-ray Endovascular Surgeon, Budgetary Institution of Khanty-Mansiysk Autonomous Okrug - Ugra “District Cardiology Hospital” of the Diagnostic and Cardiovascular Surgery Center”; graduate student at the Department of Cardiology, Budgetary Institution of Higher Education, Khanty-Mansiysk Autonomous Okrug - Ugra, “Surgut State University”.</p><p>69/1, Lenina Ave., Surgut, Khanty-Mansiysk Autonomous Okrug - Ugra, 628416.</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7014-2096</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Воробьев</surname><given-names>А. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Vorobev</surname><given-names>A. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Воробьев Антон Сергеевич - кандидат медицинских наук, доцент врач-кардиолог бюджетного учреждения Ханты-Мансийского автономного округа - Югры «Окружной кардиологический диспансер «ЦД и ССХ»; доцент кафедры кардиологии, ведущий научный сотрудник научно-образовательного центра медицинского института СурГУ.</p><p>просп. Ленина, 69/1, Ханты-Мансийский автономный округ - Югра, Сургут, 628416; просп. Ленина, 1, Ханты-Мансийский автономный округ - Югра, Сургут, 628412.</p></bio><bio xml:lang="en"><p>Anton S. Vorobiev - PhD, Associate Professor Cardiologist, Budgetary Institution of Khanty-Mansiysk Autonomous Okrug - Ugra “District Cardiology Hospital” of the Diagnostic and Cardiovascular Surgery Center”; Associate Professor at the Cardiology Department, Senior Research Assistant at the Scientific Educational Center, Surgut State Medical Institute of Higher Education, Khanty-Mansiysk Autonomous Okrug - Ugra, “Surgut State University”.</p><p>69/1, Lenina Ave., Surgut, Khanty-Mansiysk Autonomous Okrug - Ugra, 628416; 1, Lenin Ave., Surgut, Khanty-Mansiysk Autonomous Okrug - Ugra, 628412.</p></bio><email xlink:type="simple">a.s.vorobyov@gmail.com</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-5545-9826</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Урванцева</surname><given-names>И. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Urvantseva</surname><given-names>I. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Урванцева Ирина Александровна - кандидат медицинских наук, доцент, главный врач бюджетного учреждения Ханты-Мансийского автономного округа - Югры «Окружной кардиологический диспансер «ЦД и ССХ»; заведующая кафедрой кардиологии медицинского института СурГУ.</p><p>просп. Ленина, 69/1, Ханты-Мансийский автономный округ - Югра, Сургут, 628416; просп. Ленина, 1, Ханты-Мансийский автономный округ - Югра, Сургут, 628412.</p></bio><bio xml:lang="en"><p>Irina A. Urvantseva - PhD, Associate Professor, Head Doctor, Budgetary Institution of Khanty-Mansiysk Autonomous Okrug - Ugra “District Cardiology Hospital” of the Diagnostic and Cardiovascular Surgery Center”; Head of the Cardiology Department, Surgut State University.</p><p>69/1, Lenina Ave., Surgut, Khanty-Mansiysk Autonomous Okrug - Ugra, 628416; 1, Lenin Ave., Surgut, Khanty-Mansiysk Autonomous Okrug - Ugra, 628412.</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-5708-7328</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Коваленко</surname><given-names>Л. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Kovalenko</surname><given-names>L. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Коваленко Людмила Васильевна - доктор медицинских наук, профессор директор медицинского института, заведующий кафедрой патофизиологии и общей патологии.</p><p>просп. Ленина, 1, Ханты-Мансийский автономный округ - Югра, Сургут, 628412.</p></bio><bio xml:lang="en"><p>Lyudmila V. Kovalenko - PhD, Professor, Head of the Medical Institute, Head of the Department of Pathophysiology and General Pathology, Budgetary Institution of Khanty-Mansiysk Autonomous Okrug - Ugra “Surgut State University”.</p><p>1, Lenin Ave., Surgut, Khanty-Mansiysk Autonomous Okrug - Ugra, 628412.</p></bio><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-3729-616X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Кашталап</surname><given-names>В. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Kashtalap</surname><given-names>V. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Кашталап Василий Васильевич - доктор медицинских наук, доцент заведующий отделом клинической кардиологии НИИ КПССЗ; профессор кафедры кардиологии и сердечно-сосудистой хирургии КемГМУ Минздрава России.</p><p>Сосновый бульвар, 6, Кемерово, 650002; ул. Ворошилова, 22а, Кемерово, 650000.</p></bio><bio xml:lang="en"><p>Vasily V. Kashtalap - PhD, Associate Professor, Head of Clinical Cardiology Department, Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Diseases”; Professor at the Department of Cardiology and Cardiovascular Surgery of Federal State Budgetary Educational Institution of Higher Education "Kemerovo State Medical University" the Ministry of Health of the Russian Federation.</p><p>6, Sosnoviy blvd., Kemerovo, 650002; Voroshilova Street, 22a, Kemerovo, 650000.</p></bio><xref ref-type="aff" rid="aff-4"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru">Бюджетное учреждение Ханты-Мансийского автономного округа - Югры «Окружной кардиологический диспансер «Центр диагностики и сердечно-сосудистой хирургии»<country>Россия</country></aff><aff xml:lang="en">Budgetary Institution of the Khanty-Mansiysk Autonomous Okrug - Ugra “District Cardiology Dispensary” of the Center for Diagnosis and Cardiovascular Surgery”<country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru">Бюджетное учреждение Ханты-Мансийского автономного округа - Югры «Окружной кардиологический диспансер «Центр диагностики и сердечно-сосудистой хирургии»; Бюджетное учреждение высшего образования Ханты-Мансийского автономного округа - Югры «Сургутский государственный университет»<country>Россия</country></aff><aff xml:lang="en">Budgetary Institution of the Khanty-Mansiysk Autonomous Okrug - Ugra “District Cardiology Dispensary” of the Center for Diagnosis and Cardiovascular Surgery”; Surgut State University<country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru">Бюджетное учреждение высшего образования Ханты-Мансийского автономного округа - Югры «Сургутский государственный университет»<country>Россия</country></aff><aff xml:lang="en">Surgut State University<country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-4"><aff xml:lang="ru">Научно-исследовательский институт комплексных проблем сердечно-сосудистых заболеваний; Кемеровский государственный медицинский университет Министерства здравоохранения Российской Федерации<country>Россия</country></aff><aff xml:lang="en">Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Diseases”; Federal State Budgetary Educational Institution of Higher Education "Kemerovo State Medical University" of the Ministry of Health of the Russian Federation<country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2022</year></pub-date><pub-date pub-type="epub"><day>18</day><month>03</month><year>2022</year></pub-date><volume>11</volume><issue>1</issue><fpage>78</fpage><lpage>89</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Кинаш В.И., Воробьев А.С., Урванцева И.А., Коваленко Л.В., Кашталап В.В., 2022</copyright-statement><copyright-year>2022</copyright-year><copyright-holder xml:lang="ru">Кинаш В.И., Воробьев А.С., Урванцева И.А., Коваленко Л.В., Кашталап В.В.</copyright-holder><copyright-holder xml:lang="en">Kinash V.I., Vorobev A.S., Urvantseva I.A., Kovalenko L.V., Kashtalap V.V.</copyright-holder><license license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.nii-kpssz.com/jour/article/view/1047">https://www.nii-kpssz.com/jour/article/view/1047</self-uri><abstract><sec><title>Основные положения</title><p>Основные положения. Представлены актуальные литературные данные об эпидемиологии и основных причинах возникновения инфаркта миокарда 2-го типа, описаны методы диагностики и лечения пациентов данной группы. Подчеркнуты неблагоприятный прогноз больных из-за коморбидности, способствующей развитию инфаркта миокарда, необходимость усовершенствования и унификации подходов к выявлению заболевания, а также проведения наблюдательных и рандомизированных исследований для оценки тактики ведения пациентов с инфарктом миокарда 2-го типа.</p></sec><sec><title>Резюме</title><p>Резюме. В обзорной статье на основании данных клинических исследований и действующих рекомендаций актуализированы подходы к определению и дифференциальной диагностике инфаркта миокарда (ИМ) 2-го типа в клинической практике. Акцентировано внимание на принципиальном различии ИМ 1-го и 2-го типов и необходимости оценки коморбидного фона для выявления этиологических факторов развития ИМ 2-го типа. Подчеркнут дефицит данных доказательной медицины в отношении прогноза и эффективности методов лечения пациентов с ИМ 2-го типа. При этом такие больные характеризуются высокими показателями общей и сердечно-сосудистой смертности в госпитальном и отдаленном периодах заболевания, а также высокой частотой повторных госпитализаций. Таким образом, высокую важность представляют необходимость многоцентровых обсервационных исследований пациентов с ИМ 2-го типа и разработка алгоритмов лечения и реабилитации данной категории больных.</p></sec></abstract><trans-abstract xml:lang="en"><sec><title>Highlights</title><p>Highlights. The article presents relevant literary data on the epidemiology, main causes, approaches to the diagnostics and treatment of type 2 myocardial infarction patients. The authors emphasize an unfavorable prognosis in these patients due to comorbidity that leads to development of myocardial infarction. They highlight the need to improve and unify approaches to identifying this phenomenon, as well as the necessity to conduct observational and randomized studies to evaluate approaches to the treatment of type 2 myocardial infarction patients.</p></sec><sec><title>Abstract</title><p>Abstract. The article summarizes the available data from clinical trials and current guidelines, approaches to the definition and type 2 myocardial infarction (MI) differential diagnosis in clinical practice. The attention is focused on the fundamental difference between type 1 and type 2 MI and the need to consider the comorbidities for the identification of etiological factors type 2 MI development. The lack of evidencebased medical data regarding the prognosis and effective treatment of patients with type 2 MI is emphasized. Nevertheless, such patients are characterized with high rates of overall and cardiovascular mortality in hospital and long-term disease course, as well as a high rate of readmission. Thus, there is the need for multicenter observational studies of type 2 MI patients and the development of algorithms for treatment and rehabilitation of this category of patients.</p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>Инфаркт миокарда 2-го типа</kwd><kwd>Повреждение миокарда</kwd><kwd>Определение</kwd><kwd>Дифференциальная диагностика</kwd></kwd-group><kwd-group xml:lang="en"><kwd>Type 2 myocardial infarction</kwd><kwd>Myocardial injury</kwd><kwd>Definition</kwd><kwd>Differential diagnosis</kwd></kwd-group><funding-group xml:lang="ru"><funding-statement>Научная статья выполнена в рамках государственного задания (2021-2023 гг.) «Профиль метилирования ДНК у коренного и пришлого населения Югры как эпигенетический биомаркер возраст-ассоциирован-ной сердечно-сосудистой патологии и возможности ее персонализированной ранней диагностики» (научно-образовательный центр медицинского института БУ ВО ХМАО - Югры «Сургутский государственный университет», Сургут, Россия) и при информационной поддержке Научно-образовательного центра мирового уровня «Кузбасс» (Кемерово, Россия).</funding-statement></funding-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Министерство здравоохранения Российской Федерации. 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