title: Silent myocardial ischaemia: the Tan Tock Seng experience.
abstract: The results of treadmill exercise stress test (TMX) for ischaemia is based on ST-segment depression. Patients with positive test may or may not be symptomatic. This study examines if there are any differences between these two groups of patients. A total of thirty-nine patients with coronary artery disease and positive TMX results in 1988 was studied. There were 16 patients with chest pain and 23 without. They were followed-up for a mean period of 16.9 and 15.2 months respectively. The following factors were found not to be statistically significant between these two groups of patients: age, sex, race, height, weight, history of hypertension, diabetes mellitus or smoking, indication for the test, use of drugs, total and HDL-cholesterol, exercise duration and the initial double product. The difference between the maximal double product of the two groups was statistically significant (p = 0.004). In the follow-up period, in the group of patients with silent myocardial ischaemia, one had a cardiac event and one underwent revascularisation. While in the symptomatic group, two had cardiac events and seven underwent revascularisation. There were no deaths in either group. The difference in overall outcome was significant statistically (p = 0.002). Therefore, patients with silent myocardial ischaemia have a higher maximal double product in TMX; hence a higher maximal workload and a less adverse outcome compared to symptomatic patients.
authors.affiliation: Cardiological Unit, Tan Tock Seng Hospital, Singapore.
authors.forename: K H
authors.initials: KH
authors.lastname: Mak
authors.forename: E K
authors.initials: EK
authors.lastname: Tan
authors.forename: L
authors.initials: L
authors.lastname: Chew
authors.forename: S H
authors.initials: SH
authors.lastname: Gan
authors.forename: A L
authors.initials: AL
authors.lastname: Chan
mesh_terms: D003327:Coronary Disease / Q000175:diagnosis* / Q000503:physiopathology; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged