# Improving the Health Status of Individuals with Type 2 Myocardial Infarction

> **NIH NIH K23** · MASSACHUSETTS GENERAL HOSPITAL · 2024 · $196,384

## Abstract

Project Abstract
Acute myocardial infarction (MI) is characterized by myocardial necrosis due to coronary ischemia and may be
precipitated by several mechanisms. Coronary plaque rupture causes ‘type 1 MI,’ the subject of intense
investigation for several decades and now with several therapies demonstrated to reduce mortality and
improve health status. However, it is now recognized that at least 1 in 5 MIs are ‘type 2 MI,’ which occurs due
to a mismatch in myocardial oxygen supply/demand precipitated by a preceding physiologic stress. Persons
with type 2 MI are usually older and have more comorbidities than persons with type 1 MI. However, it is
unknown whether these characteristic differences translate to differences in health status. Type 2 MI is
associated with a poor prognosis; only 40% of individuals are alive at 5 years. Unfortunately, despite the
frequency and prognosis of type 2 MI, evidence-based treatment strategies are lacking due to an absence of
clinical trials. Exercise-based cardiac rehabilitation (CR) is demonstrably efficacious for type 1 MI. However,
CR is virtually unused for type 2 MI. Increasing adoption of CR, a covered therapy, may improve outcomes for
persons with type 2 MI. The aims of this research proposal are to (1) determine if differences exist in patient-
reported health status between persons with type 2 versus type 1 MI, (2) obtain key information from patients
and clinicians on the perceived benefits, acceptability, evidence requirement, and barriers to attendance at CR
for type 2 MI compared to type 1 MI, and (3) undertake a pilot hybrid effectiveness-implementation clinical trial
to assess if a multifaceted intervention increases attendance at CR and is potentially efficacious in improving
health status for persons with type 2 MI as compared to usual care. For this latter aim, physicians will receive a
reminder to consider referral to CR and patients will receive access to a patient engagement platform, with CR
appointment reminders. Successful completion of the proposed studies will inform whether health status differs
according to the subtype of MI and will explore if a multilevel intervention can increase CR attendance and
potentially improve health status for those with type 2 MI. The objectives of this research award are to (1)
develop an expertise in health status assessment and patient reported outcome measures, (2) learn how to
design and interpret patient and clinician surveys, and 3) develop an expertise in clinical trial design, execution,
and interpretation. Dr. McCarthy’s career goals are to undertake clinical trials that identify treatment
approaches for individuals with type 2 MI. The findings from this proposal will form the foundation of Dr.
McCarthy’s R01 application for a definitive effectiveness-implementation trial of CR for type 2 MI. Dr.
McCarthy’s mentors and scientific advisors are experts in CR, qualitative and quantitative research, patient-
reported outcome measures, and clinical tria...

## Key facts

- **NIH application ID:** 10903727
- **Project number:** 5K23HL167659-02
- **Recipient organization:** MASSACHUSETTS GENERAL HOSPITAL
- **Principal Investigator:** Cian Patrick McCarthy
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $196,384
- **Award type:** 5
- **Project period:** 2023-08-09 → 2028-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10903727

## Citation

> US National Institutes of Health, RePORTER application 10903727, Improving the Health Status of Individuals with Type 2 Myocardial Infarction (5K23HL167659-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10903727. Licensed CC0.

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