As I have lectured in didactics, a paradigm shift is taking place toward the OMI vs nonOMI, and perhaps moving away from STEMI vs nSTEMI.

The ACC may be getting on board with this change that began with ER docs, chiefly Stephen Smith at Hennepin. *Unstable Angina still exists.

Check out his tweet linking to the paper:

1/2 For first time, the Am Coll of Cardiology recognizes Occlusion MI in clinical guidelines (and references our first of many OMI/NOMI studies: Meyers HP, … Smith SW. Comparison of STEMI vs. NSTEMI & OMI vs. NOMI Paradigms of AMI. J Emerg Med 2020) https://jacc.org/doi/epdf/10.1016/j.jacc.2022.08.750

2/2 And also, for the first time in any Guideline (as far as I know), they recommend EKG criteria that were developed by an Emergency Physician (Smith Modified Sgarbossa Criteria). Page 7 of the pdf, references 10, 11, 21. https://jacc.org/doi/epdf/10.1016/j.jacc.2022.08.750