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Occurrence of unrecognized myocardial infarction in subjects aged 45 to 65 years (the ARIC study).

TitleOccurrence of unrecognized myocardial infarction in subjects aged 45 to 65 years (the ARIC study).
Publication TypeJournal Article
Year of Publication2002
AuthorsBoland LL, Folsom AR, Sorlie PD, Taylor HA, Rosamond WD, Chambless LE, Cooper LS
JournalAm J Cardiol
Volume90
Issue9
Pagination927-31
Date Published2002 Nov 01
ISSN0002-9149
KeywordsAfrican Continental Ancestry Group, Aged, Cholesterol, HDL, Cholesterol, LDL, Cohort Studies, Diabetes Complications, Diabetes Mellitus, European Continental Ancestry Group, Evidence-Based Medicine, Female, Follow-Up Studies, Humans, Hypertension, Incidence, Male, Middle Aged, Myocardial Infarction, Prospective Studies, Risk Factors, United States
Abstract

Previous observational studies conducted predominantly in white men before 1988 estimated that 20% to 40% of myocardial infarctions (MIs) are unrecognized. Recent data on the proportion of MIs that are unrecognized, especially in women and African-Americans, are largely unavailable. Participants in the Atherosclerosis Risk in Communities (ARIC) study were men and women, aged 45 to 65 years, who were free of clinically recognized coronary heart disease and electrocardiographic evidence of MI at baseline (n = 12,843). Three follow-up clinic examinations were conducted approximately 3, 6, and 9 years after baseline, and included a 12-lead electrocardiogram at rest. Electrocardiographic evidence of infarction was defined as the appearance between the baseline and subsequent examinations of a major Q wave or a minor Q wave with ischemic ST-T changes. Clinically recognized (hospitalized) MI events were also identified and validated. Incident unrecognized MI was defined as electrocardiographic evidence of MI before, or in the absence of, a clinically recognized MI during the follow-up period. Of 508 MIs, 20% were unrecognized (95% confidence interval 16% to 23%), with African-Americans having a slightly higher percentage (23%) than whites (19%). The percentage of unrecognized MIs in men and women was similar. The percentage of unrecognized MIs in the ARIC sample between 1987 and 1998 was slightly lower than previous estimates from other populations.

DOI10.1016/s0002-9149(02)02655-3
Alternate JournalAm J Cardiol
PubMed ID12398956
Grant ListN01-HC-55015 / HC / NHLBI NIH HHS / United States
N01-HC-55016 / HC / NHLBI NIH HHS / United States
N01-HC-55018 / HC / NHLBI NIH HHS / United States
N01-HC-55019 / HC / NHLBI NIH HHS / United States
N01-HC-55020 / HC / NHLBI NIH HHS / United States
N01-HC-55021 / HC / NHLBI NIH HHS / United States
N01-HC-55022 / HC / NHLBI NIH HHS / United States