Prevalence of and association between silent myocardial ischemia and new coronary events in older men and women with and without cardiovascular disease.
OBJECTIVE
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.


METHODS
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.


METHODS
Large long-term healthcare facility.


METHODS
Nine hundred fifteen men, mean age 80, and 1,874 women, mean age 81.


METHODS
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.
Department of Geriatrics and Adult Development, Mount Sinai School of Medicine, New York, NY, USA. wsaranow@aol.com
Wilbert S
WS
Aronow
Chul
C
Ahn
Anthony D
AD
Mercando
Stanley
S
Epstein
Itzhak
I
Kronzon
D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000150:complications / Q000453:epidemiology*; D016757:Death, Sudden, Cardiac / Q000453:epidemiology*; D015716:Electrocardiography, Ambulatory; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000453:epidemiology*; D017202:Myocardial Ischemia / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology*; D015995:Prevalence; D011446:Prospective Studies