Prevalence, Consequences, and Implications for Clinical Trials of Unrecognized Myocardial Infarction

Patients with myocardial infarction (MI) generally present with chest pain or pressure at rest or minimal exertion and have associated electrocardiographic changes and/or elevation of the biomarkers of myocardial necrosis. A subset of patients, however, experience little chest discomfort or do not p...

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Bibliographic Details
Published in:The American journal of cardiology 2013-03, Vol.111 (6), p.914-918
Main Authors: Pride, Yuri B., MD, Piccirillo, Bryan J., MD, Gibson, C. Michael, MS, MD
Format: Article
Language:English
Subjects:
Acute coronary syndromes
Atherosclerosis
Biomarkers - analysis
Cardiovascular
Cardiovascular disease
Clinical trials
Diabetes
Diagnostic Imaging
Electrocardiography
Heart
Heart attacks
Humans
Incidence
Mens health
Myocardial Infarction - complications
Myocardial Infarction - diagnosis
Myocardial Infarction - epidemiology
Prevalence
Randomized Controlled Trials as Topic
Womens health
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Description
Summary:Patients with myocardial infarction (MI) generally present with chest pain or pressure at rest or minimal exertion and have associated electrocardiographic changes and/or elevation of the biomarkers of myocardial necrosis. A subset of patients, however, experience little chest discomfort or do not present to medical attention despite experiencing symptoms. Unrecognized MI might be detected using electrocardiographic or imaging techniques, such as echocardiography, nuclear imaging, or cardiovascular magnetic resonance imaging. Unrecognized MI is a common clinical entity, with an incidence as great as 35% in high-risk populations. Moreover, the risk of a subsequent major adverse cardiovascular event might be similar to the risk after a clinically apparent MI. In the present review, we examined the incidence of unrecognized MI across broad groups of subjects and the subsequent risk of adverse cardiovascular events. Finally, we explored the potential role of including unrecognized MI as a major adverse outcome in randomized clinical trials of agents aimed at reducing cardiovascular morbidity.
ISSN:0002-9149
1879-1913
DOI:10.1016/j.amjcard.2012.11.042