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Prevalence of and Association Between Silent Myocardial Ischemia and New Coronary Events in Older Men and Women with and without Cardiovascular Disease
Author(s) -
Aronow Wilbert S.,
Ahn Chul,
Mercando Anthony D.,
Epstein Stanley,
Kronzon Itzhak
Publication year - 2002
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1046/j.1532-5415.2002.50263.x
Subject(s) - medicine , coronary artery disease , incidence (geometry) , cardiology , cardiomyopathy , valvular heart disease , disease , ambulatory , heart failure , physics , optics
OBJECTIVES: To investigate the prevalence of silent ischemia (SI) in older men and women detected by 24‐hour ambulatory electrocardiograms (AECGs) and the association between SI and new coronary events. DESIGN: In a prospective study, the prevalence of SI detected by 24‐hour AECGs and the incidence of new coronary events in 915 older men and 1,874 older women with coronary artery disease (CAD); with hypertension, valvular disease, or cardiomyopathy without CAD; and with no cardiovascular disease were investigated. SETTING: Large long‐term healthcare facility. PARTICIPANTS: Nine hundred fifteen men, mean age 80, and 1,874 women, mean age 81. MEASUREMENTS: The prevalence of SI and the incidence of new coronary events in older men and women. RESULTS: SI was present in 34% of men and 33% of women with CAD; 15% of men and 14% of women with hypertension, valvular disease, or cardiomyopathy without CAD; and 6% of men and 5% of women with no cardiovascular disease. At 45‐month follow‐up in men and 47‐month follow‐up in women, SI significantly increased the incidence of new coronary events by 2.0 times in men and women with CAD ( P < .001); by 1.8 times in men and 1.7 times in women with hypertension, valvular disease, or cardiomyopathy without CAD ( P < .001); and by 6.3 times in men ( P = .018) and 4.4 times in women ( P = .008) with no cardiovascular disease. CONCLUSIONS: SI increases the incidence of new coronary events in older men and women with CAD, with hypertension, valvular disease, or cardiomyopathy without CAD, and with no cardiovascular disease.