Canadian Cardiovascular Society

CCS Classification of Acute Myocardial Infarction (CCS-AMI)

On October 28, 2023, the Canadian Cardiovascular Society Classification of Acute Myocardial Infarction (CCS-AMI) – a new, never-before released classification of four stages of heart attack – was published in the Canadian Journal of Cardiology. A presentation at the Vascular 2023 conference in Montréal followed on October 29.

This is the first heart attack classification of its kind to be released within Canada and internationally. The classification will help physicians and cardiac health care providers better estimate and predict a patient’s risk of developing heart failure, arrhythmia, or dying. It will also open new avenues of research for more precise and individualized therapies to address the underlying damage at each heart attack stage.

The CCS-AMI Classification describes damage to the heart muscle following an MI in four sequential and progressively severe stages. It is based on a strong body of evidence about the effect an MI has on the heart muscle.

The four CCS-AMI stages are:

  • CCS Stage 1 – No or minimal damage to the heart muscle.
  • CCS Stage 2 – Damage to the heart muscle and no injury to small blood vessels in the heart.
  • CCS Stage 3 – Damage to the heart muscle and blockage of small blood vessels in the heart.
  • CCS Stage 4 – Damage to the heart muscle, blockage and rupture of small blood vessels resulting in bleeding into the heart muscle.
Back to top