Unrecognized Myocardial Infarction: Epidemiology, Clinical Characteristics, and the Prognostic Role of Angina Pectoris: The Reykjavik Study

Sigurðsson, Emil L.

doi:10.7326/0003-4819-122-2-199501150-00003

Cited by 212 publications

(163 citation statements)

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“…It is uncertain whether traditional risk factors for RMI also account fully for unrecognized MI (UMI) or whether UMI has additional risk factors 8, 9, 10, 11. By comparison with RMI, risk factors for development of UMI are less clearly defined because of inability to detect UMI accurately.…”

Section: Introductionmentioning

confidence: 99%

“…Using usual diagnostic clinical criteria, there can be underreporting of UMI for several reasons including missed diagnosis, lack of symptoms, insensitivity of 12‐lead ECG, or in some cases, regression of q waves with time 4, 12, 13, 14, 15. Therefore, UMI, which carries a significant risk of subsequent adverse cardiac events,16, 17 may be underestimated for prospective modification of risk 11, 17, 18…”

Section: Introductionmentioning

confidence: 99%

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Midlife Cardiovascular Risk Factors and Late‐Life Unrecognized and Recognized Myocardial Infarction Detect by Cardiac Magnetic Resonance: ICELAND‐MI, the AGES‐Reykjavik Study

McAreavey

Vidal

Aspelund

et al. 2016

JAHA

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BackgroundAssociations of atherosclerosis risk factors with unrecognized myocardial infarction (UMI) are unclear. We investigated associations of midlife risk factors with UMI and recognized MI (RMI) detected 31 years later by cardiac magnetic resonance.Methods and ResultsThe Reykjavik Study (1967–1991) collected serial risk factors in subjects, mean (SD) age 48 (7) years. In ICELAND‐MI (2004–2007), 936 survivors (76 (5) years) were evaluated by cardiac magnetic resonance. Analysis included logistic regression and random effects modeling. Comparisons are relative to subjects without MI. At baseline midlife evaluation, a modified Framingham risk score was significantly higher in RMI and in UMI versus no MI (7.4 (6.3)%; 7.1 (6.2)% versus 5.4 (5.8)%, P<0.001). RMI and UMI were more frequent in men (65%, 64% versus 43%; P<0.0001). Baseline systolic and diastolic blood pressure were significantly higher in UMI (138 (17) mm Hg versus 133 (17) mm Hg; P<0.006; 87 (10) mm Hg versus 84 (10) mm Hg; P<0.02). Diastolic BP was significantly higher in RMI (88 (10) mm Hg versus 84 (10) mm Hg; P<0.02). Cholesterol and triglycerides were significantly higher in RMI (6.7 (1.1) mmol/L versus 6.2 (1.1) mmol/L; P=0.0005; and 1.4 (0.7) mmol/L versus 1.1 (0.7) mmol/L; P<0.003). Cholesterol trended higher in UMI (P=0.08). Serial midlife systolic BP was significantly higher in UMI versus no MI (β [SE] = 2.69 [1.28] mm Hg, P=0.04). Serial systolic and diastolic BP were significantly higher in RMI versus no MI (4.12 [1.60] mm Hg, P=0.01 and 2.05 [0.91] mm Hg, P=0.03) as were cholesterol (0.43 [0.11] mmol/L, P=0.0001) and triglycerides (0.3 [0.06] mmol/L, P<0.0001).ConclusionsMidlife vascular risk factors are associated with UMI and RMI detected by cardiac magnetic resonance 31 years later. Systolic blood pressure was the most significant modifiable risk factor associated with later UMI.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Midlife Cardiovascular Risk Factors and Late‐Life Unrecognized and Recognized Myocardial Infarction Detect by Cardiac Magnetic Resonance: ICELAND‐MI, the AGES‐Reykjavik Study

McAreavey

Vidal

Aspelund

et al. 2016

JAHA

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“…Unrecognised MIs may be present in about 3.5% of 70-year-old men in the general population (17). Studies indicate that their prognosis does not differ significantly from that of patients with recognised infarctions (17)(18)(19).…”

Section: How Exact Is the E6idence?mentioning

confidence: 99%

“…Studies indicate that their prognosis does not differ significantly from that of patients with recognised infarctions (17)(18)(19). Evidence-based calculations of upon the kind of doctor/GP we would like to be -in our own view and in the eyes of the patient (Table II).…”

Section: How Exact Is the E6idence?mentioning

confidence: 99%

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A matter of heart: the general practitioner consultation in an evidence-based world

Getz

Nilsson²,

Hetlevik

2003

Scandinavian Journal of Primary Health Care

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Prevalence and Prognosis of Unrecognized Myocardial Infarction Determined by Cardiac Magnetic Resonance in Older Adults

Schelbert¹,

Cao²,

Sigurðsson³

et al. 2012

JAMA

251

219

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HE PREVALENCE AND PROGNOsis of unrecognized myocardial infarction (MI) in older people with and without diabetes may be higher than previously suspected in population studies. [1][2][3][4] Advances in MI detection, such as cardiac magnetic resonance (CMR) imaging with late gadolinium enhancement (LGE), are more sensitive than prior methods. 5 Ascertaining the prevalence of unrecognized MI (UMI) in these groups is relevant because age and diabetes increase the risks of coronary heart disease. 6 Pathologic studies 7 indicate that subclinical coronary plaque rupture occurs frequently, particularly in diabetic individuals, which may culminate in a high prevalence of UMI.Several population studies 1-4 have described the prevalence of UMI based on electrocardiography (ECG), but ECG Author Affiliations are listed at the end of this article.

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Unrecognized Myocardial Infarction: Epidemiology, Clinical Characteristics, and the Prognostic Role of Angina Pectoris: The Reykjavik Study

Cited by 212 publications

References 0 publications

Midlife Cardiovascular Risk Factors and Late‐Life Unrecognized and Recognized Myocardial Infarction Detect by Cardiac Magnetic Resonance: ICELAND‐MI, the AGES‐Reykjavik Study

Midlife Cardiovascular Risk Factors and Late‐Life Unrecognized and Recognized Myocardial Infarction Detect by Cardiac Magnetic Resonance: ICELAND‐MI, the AGES‐Reykjavik Study

A matter of heart: the general practitioner consultation in an evidence-based world

Prevalence and Prognosis of Unrecognized Myocardial Infarction Determined by Cardiac Magnetic Resonance in Older Adults

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