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[Silent myocardial ischemia: its increase with aging]
A de C Azevedo1, P J de Souza, M S Bueno
1Pontifícia Universidade Católica Laboratório Tecnocordis, Rio de Janeiro.
Insights
Silent myocardial ischemia episodes and their duration increase with age. This study found that older patients with coronary obstructions experienced more frequent and longer silent ischemia events, even while on anti-anginal medication.
Area of Science:
- Cardiology
- Geriatrics
- Ischemic Heart Disease
Context:
- Silent myocardial ischemia is a significant concern in patients with coronary artery disease.
- Aging is a known risk factor for cardiovascular diseases.
- Understanding how ischemia changes with age is crucial for patient management.
Purpose:
- To investigate the relationship between patient age and the occurrence and duration of silent myocardial ischemia.
- To determine if silent myocardial ischemia episodes increase with aging in patients with coronary obstructions.
Summary:
- A Holter monitoring study of 1,300 patients, with 330 selected for analysis, assessed silent myocardial ischemia in four age groups.
- Results showed a progressive increase in both the number and duration of silent myocardial ischemia episodes with advancing age.
- The proportion of patients with ischemia and the duration of ischemic episodes significantly increased in older age groups.
Impact:
- Silent myocardial ischemia is prevalent even during anti-anginal treatment, predominantly in its silent form.
- Findings highlight the increased burden of silent myocardial ischemia in older adults.
- This research underscores the need for age-specific considerations in managing silent myocardial ischemia.
Purpose:
To evaluate whether the number and duration of the episodes of silent myocardial ischemia increase with aging of patients.
Methods:
A Holter monitoring, with CardioData equipment, was made in 1,300 patients and 330 with proven significant coronary obstructions were selected for this study. The anti-anginal medication was maintained during the 24 or 48 hours of Holter recording. The patients were arbitrarily divided into four groups according to age less than 50 years, 50 to 59 years, 60 to 69 years and greater than or equal to 70 years old. The statistical analysis was made with two models, the model of logistic regression and the Poisson model.
Results:
Myocardia ischemia was detected in 72 patients (21.8%), 55 (76%) had only silent episodes, 6 (9%) had only anginal ischemia and 11 patients (155) had both silent and anginal ischemia. There was a progressive increase in the number and duration of the episodes of myocardial ischemia with aging. The proportion of patients with episodes of myocardial ischemia in the 4 age groups was 12.12%, 19.75%, 22.25% and 31.48% and the duration of the episodes of ischemia per patient 37, 37.5, 50.8 and 85.1 minutes, respectively. Statistical analysis showed a significant increase with aging in number and duration of the episodes.
Conclusions:
Myocardial ischemia is still present in asymptomatic patients during anti-anginal treatment and the ischemia is mainly silent. There is a progressive increase with aging in number and duration of the episodes of ischemia.