[Silent ischemia after an uncomplicated myocardial infarct. A study in asymptomatic patients].
OBJECTIVE
To verify the prognostic value of silent myocardial ischemia (SMI) after an uncomplicated myocardial infarction (MI).


METHODS
Forty asymptomatic patients were studied after a first uncomplicated MI. They were submitted to 48 hour ambulatory electrocardiographic monitoring and exercise-testing, during the 2nd and 8th weeks after the acute event. Thirty-nine patients were submitted to cardiac catheterization and coronary arteriography; one patient was submitted to necropsy. The electrocardiographic study identified 11 (27.5%) individuals with SMI (group A); the other 29 patients were considered group B.


RESULTS
Groups A and B were similar in relation to clinical characteristics, infarct site and ventricular function. Group A had significantly more extensive coronary artery disease when compared to group B. After a two-year follow-up, patients from group A had significantly more coronary events (36.3%) when compared to group B (3.4%). Kaplan-Meier analysis demonstrated a significantly higher cumulative probability of not experiencing a new coronary event for the group B patients.


CONCLUSIONS
SMI may have a prognostic value after uncomplicated MI, as in other clinical manifestations of coronary artery disease.
Solimene
M C
MC
Instituto do Coração do Hospital das Clínicas, FMUSP.
Ramires
J A
JA
Grupi
C J
CJ
Alfieri
R G
RG
Oliveira
S F
SF
Gama
M N
MN
Bellotti
G
G
Pileggi
F
F
D000328:Adult; D000368:Aged; D001938:Brazil / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology / Q000401:mortality; D017202:Myocardial Ischemia / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology / Q000401:mortality; D011379:Prognosis; D012307:Risk Factors
Isquemia silenciosa após infarto do miocárdio não complicado. Estudo em pacientes assintomáticos.