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Silent Myocardial Infarction and Long-Term Risk of Heart Failure: The ARIC Study.

TitleSilent Myocardial Infarction and Long-Term Risk of Heart Failure: The ARIC Study.
Publication TypeJournal Article
Year of Publication2018
AuthorsQureshi WT, Zhang Z-M, Chang PP, Rosamond WD, Kitzman DW, Wagenknecht LE
Secondary AuthorsSoliman EZ
JournalJ Am Coll Cardiol
Volume71
Issue1
Pagination1-8
Date Published2018 01 02
ISSN1558-3597
KeywordsAged, Asymptomatic Diseases, Electrocardiography, Female, Heart Failure, Humans, Incidence, Male, Middle Aged, Myocardial Infarction, Outcome Assessment, Health Care, Proportional Hazards Models, Risk Assessment, Risk Factors, United States
Abstract

BACKGROUND: Although silent myocardial infarction (SMI) accounts for about one-half of the total number of myocardial infarctions (MIs), the risk of heart failure (HF) among patients with SMI is not well established.

OBJECTIVES: The purpose of this study was to examine the association of SMI and clinically manifested myocardial infarction (CMI) with HF, as compared with patients with no MI.

METHODS: This analysis included 9,243 participants from the ARIC (Atherosclerosis Risk In Communities) study who were free of cardiovascular disease at baseline (ARIC visit 1: 1987 to 1989). SMI was defined as electrocardiographic evidence of MI without CMI after the baseline until ARIC visit 4 (1996 to 1998). HF events were ascertained starting from ARIC visit 4 until 2010 in individuals free of HF before that visit.

RESULTS: Between ARIC visits 1 and 4, 305 SMIs and 331 CMIs occurred. After ARIC visit 4 and during a median follow-up of 13.0 years, 976 HF events occurred. The incidence rate of HF was higher in both CMI and SMI participants than in those without MI (incidence rates per 1,000 person-years were 30.4, 16.2, and 7.8, respectively; pĀ 

CONCLUSIONS: SMI is associated with an increased risk of HF. Future research is needed to examine the cost effectiveness of screening for SMI as part of HF risk assessment, and to identify preventive therapies to improve the risk of HF among patients with SMI.

DOI10.1016/j.jacc.2017.10.071
Alternate JournalJ Am Coll Cardiol
PubMed ID29301615
PubMed Central IDPMC5757248
Grant ListHHSN268201100012C / HL / NHLBI NIH HHS / United States
HHSN268201100009I / HL / NHLBI NIH HHS / United States
HHSN268201100010C / HL / NHLBI NIH HHS / United States
HHSN268201100008C / HL / NHLBI NIH HHS / United States
HHSN268201100005G / HL / NHLBI NIH HHS / United States
HHSN268201100008I / HL / NHLBI NIH HHS / United States
HHSN268201100007C / HL / NHLBI NIH HHS / United States
HHSN268201100011I / HL / NHLBI NIH HHS / United States
HHSN268201100011C / HL / NHLBI NIH HHS / United States
HHSN268201100006C / HL / NHLBI NIH HHS / United States
HHSN268201100005I / HL / NHLBI NIH HHS / United States
HHSN268201100009C / HL / NHLBI NIH HHS / United States
HHSN268201100005C / HL / NHLBI NIH HHS / United States
HHSN268201100007I / HL / NHLBI NIH HHS / United States