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International Classification of Diseases, Tenth Revision (ICD‑10) codes are commonly used for identifying myocardial infarction (MI) in clinical research and increasingly used to capture events in clinical trials, however, their accuracy for distinguishing MI subtypes is uncertain. In a study of 24,524 individuals undergoing troponin testing, type 1 MI ICD‑10 codes showed moderate sensitivity (53%) but high specificity (99%), whereas the ICD-10 codes for type 2 MI and types 3-5 MI demonstrated extremely low sensitivity (3% and 0%, respectively) despite high specificity (99%). These data suggest that ICD‑10 codes for each individual MI subtype have such low sensitivity that they may not reliably and accurately identify these MI subtypes in clinical research or in quality metrics and value-based programs.