Zionsville resident develops new clinical classification

Zionsville resident Dr. Rohan Dharmakumar, executive director of the Krannert Cardiovascular Research Center at the Indiana University School of Medicine, and his colleague Dr. Andreas Kumar from Northern Ontario School of Medicine, worked together to develop the world’s first clinical classification of heart attacks based on tissue damage, which the Canadian Cardiovascular Society recently adopted.

According to Angie Antonopoulos, communications generalist at the Indiana University School of Medicine, the new classification introduces new standards of care for treatment in Canada for the first time that might bring more customized care at each stage of cardiovascular disease.

The four-stage classification, CCS-AMI, was presented at the Vascular 2023 conference on Oct. 29 in Montréal, Canada, and published in the Canadian Journal of Cardiology.

According to the IU School of Medicine, Dharmakumar has two decades of experience in myocardial infarction research.

“What we’ve learned over the past decade using advanced imaging is that when you open a blocked blood vessel of the heart, it can, at times, lead to substantially more tissue damage,” Dharmakumar stated. “(In) some patients, this can drive electrical instabilities (arrhythmias) or ventricular remodeling that can then lead to heart failure, hospitalization or death.”

The CCS-AMI Classification outlines damage to the heart muscle following a heart attack in four stages based on decades of research:

• CCS Stage 1 myocardial infarction: Aborted myocardial infarction
• CCS Stage 2 myocardial infarction: Cardiomyocyte necrosis without microvascular injury
• CCS Stage 3 myocardial infarction: Cardiomyocyte necrosis and microvascular obstruction
• CCS Stage 4 acute myocardial infarction: Cardiomyocyte necrosis, microvascular obstruction and reperfusion hemorrhage

“This classification establishes the crucial framework needed so new therapies can be developed to maximize impact on patient outcomes,” Dharmakumar stated. “I am hopeful that CCS-AMI Classification will spur on new guidelines by various cardiovascular societies around the world, so cardiovascular patients everywhere can benefit from more tailored interventional cardiac care.”