Prevalence, incidence and prognosis of recognized and unrecognized myocardial infarction in persons aged 75 years or older: The Bronx Aging Study

Nadelmann, Jeremy; Frishman, William H.; Ooi, Wee Lock; Tepper, David; Greenberg, Steven M.; Guzik, Howard; Lazar, Eliot J.; Heiman, Mark; Aronson, Miriam K.

doi:10.1016/0002-9149(90)90477-i

Cited by 152 publications

(56 citation statements)

References 15 publications

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“…This proportion is greater than in the general population, with most studies reporting that 40% or less of MIs are silent [1,2,3]. As in previous smaller scale studies [8,9], our diabetic patients with silent MI were more likely to be women and hypertensive.…”

Section: Discussionsupporting

confidence: 46%

“…An Israeli study showed that the 7-year mortality associated with clinical MIs was more than four times that in the silent MI group [1]. In another study [3], silent and clinical MI had the same all-cause mortality. These heterogeneous results might reflect differences in study design and methods of analysis, but genetic and environmental factors could have played key roles.…”

Section: Discussionmentioning

confidence: 97%

“…University of Western Australia, School of Medicine and Pharmacology, Fremantle Hospital, Fremantle, Australia than, similar to, or lower than those in patients with known MI [1,2,3]. Although their numbers are relatively small and clinical details are often incomplete, diabetic patients included in population-based studies do not have an increased propensity to silent MI [4].…”

Section: T M E Davis · P Fortun · J Mulder · W a Davis · D Gmentioning

confidence: 99%

“…In cross-sectional studies in the general population, 15 to 40% of patients with ECG evidence of past myocardial infarction (MI) do not give a history of typical cardiac symptoms [1,2,3]. Mortality rates in patients with such "silent" MIs have been reported as higher…”

Section: T M E Davis · P Fortun · J Mulder · W a Davis · D Gmentioning

confidence: 99%

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Silent myocardial infarction and its prognosis in a community-based cohort of Type 2 diabetic patients: the Fremantle Diabetes Study

et al. 2004

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Aims/hypothesis. Our study investigated the prognosis of Type 2 diabetic patients with silent myocardial infarction in a community-based cohort. Methods. We analysed data from 1269 patients with Type 2 diabetes mellitus from a community-based observational study of diabetes care, control and complications. Silent myocardial infarction was defined as Q waves (Minnesota codes 1.1, 1.2) on a baseline electrocardiogram in the absence of a history or symptoms of CHD. Results. Silent myocardial infarction was present in 3.9% of patients, or 44% of all Q-wave myocardial infarctions. The patients were subdivided into those with (i) no clinical or Q-wave evidence of myocardial infarction (Group 1), (ii) silent myocardial infarction (Group 2), (iii) self-reported CHD but no Q waves (Group 3), and (iv) self-reported CHD and Q waves (Group 4). Compared to Groups 3 and 4, Group 2 patients were more likely to be women, less likely to have smoked, and had higher serum HDL-cholesterol concentrations and higher blood pressure. Over an average of seven years, and after adjusting for other independent predictors of death, all-cause and CHD mortality were similar in Groups 1 and 2 and greater (twofold for all-cause and fourfold for CHD mortality) in Groups 3 and 4. Conclusions/interpretation. Silent myocardial infarction is common in Type 2 diabetes and has a prognosis similar to that in patients without a history of CHD or Q waves. [Diabetologia (2004) 47:395-399]

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Section: Discussionsupporting

confidence: 46%

Section: Discussionmentioning

confidence: 97%

Section: T M E Davis · P Fortun · J Mulder · W a Davis · D Gmentioning

confidence: 99%

Section: T M E Davis · P Fortun · J Mulder · W a Davis · D Gmentioning

confidence: 99%

See 2 more Smart Citations

Silent myocardial infarction and its prognosis in a community-based cohort of Type 2 diabetic patients: the Fremantle Diabetes Study

et al. 2004

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“…Q waves noted on screening ECGs are important as markers for unrecognized cardiac disease. Estimates regarding the proportion of actual infarctions that go unrecognized, the syndrome of painless myocardial infarction, vary, but the average is between 15% and 30%, increasing with age (Nadelmann et al, 1990). Study data suggests that for the age group 40 to 59, even 1 silent myocardial infarction in 100 patients could be identified by routine screening (Ashley et al, 2001).…”

Section: Ecg Screeningmentioning

confidence: 99%

The Role of Standard 12-lead ECG in a Telecardiology Consultation Service

Nikus¹,

Virtanen²,

Sclarovsky³

et al. 2011

Telemedicine Techniques and Applications

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Symptom Presentation of Women With Acute Coronary Syndromes

et al. 2007

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Background: Optimal diagnosis and timely treatment of patients with an acute coronary syndrome (ACS) depends on distinguishing differences between popular "myths" about ischemic symptoms in women and men. Chest pain or discomfort is regarded as the hallmark symptom of ACS, and its absence is regarded as "atypical" presentation. This review describes the presenting symptoms of ACS in women compared with men and ascertains whether women should have a symptom message that is separate or different from that for men. Methods: MEDLINE (1970-2005), bibliographies of articles, and pertinent abstracts were reviewed, focusing on studies of ACS presentation, especially those reporting differences in symptoms by sex. This analysis included 69 of 361 possible studies. Data regarding symptom presentation were recorded. Results: The published literature lacks standardization in characterizing ACS presentation, data collection, and reporting of symptoms. Approximately one-third of patients in the large cohort studies and one-quarter of patients in the smaller reports and direct patient interviews presented without chest pain or discomfort. The absence of chest pain or discomfort with ACS was noted more commonly in women than in men in both the cumulative summary from large cohort studies (37% vs 27%) and the single-center and small reports or interviews (30% vs 17%). Conclusions: Women are significantly less likely to report chest pain or discomfort compared with men. These differences, however, are not likely large enough to warrant sex-specific public health messages regarding the symptoms of ACS at the present time. Further research must systematically investigate sex differences in the clinical presentation of ACS symptoms and must include standardized data collection efforts.

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Prevalence, incidence and prognosis of recognized and unrecognized myocardial infarction in persons aged 75 years or older: The Bronx Aging Study

Cited by 152 publications

References 15 publications

Silent myocardial infarction and its prognosis in a community-based cohort of Type 2 diabetic patients: the Fremantle Diabetes Study

Silent myocardial infarction and its prognosis in a community-based cohort of Type 2 diabetic patients: the Fremantle Diabetes Study

The Role of Standard 12-lead ECG in a Telecardiology Consultation Service

Symptom Presentation of Women With Acute Coronary Syndromes

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