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Unrecognised myocardial infarction in subjects at high vascular risk: prevalence and determinants

M F L Meijs1, M L Bots, M J M Cramer

  • 1Department of Cardiology, University Medical Center Utrecht, Utrecht 3584 CX, The Netherlands.

Heart (British Cardiac Society)
|February 17, 2009
PubMed

Insights

Unrecognised myocardial infarction (UMI) is common in asymptomatic individuals with high vascular risk. The prevalence of UMI increases significantly with a greater number of vascular risk factors, highlighting the need for early detection.

Area of Science:

  • Cardiology
  • Vascular Medicine
  • Diagnostic Imaging

Background:

  • Unrecognised myocardial infarction (UMI) represents a significant burden of cardiovascular disease.
  • Identifying determinants of UMI is crucial for risk stratification and prevention strategies.

Purpose of the Study:

  • To determine the prevalence of unrecognised myocardial infarction (UMI) in individuals with established atherosclerotic disease or significant risk factors.
  • To investigate the factors associated with the presence of UMI in this high-risk population.

Main Methods:

  • A cross-sectional study involving 502 participants with manifest extracardiac atherosclerotic disease or marked atherosclerosis risk factors.
  • Delayed enhancement cardiac MRI (DE-CMR) was utilized to detect both Q-wave and non-Q wave myocardial infarctions.
  • UMI was defined as evidence of myocardial infarction on DE-CMR without a corresponding clinical history.

Main Results:

  • A significant prevalence of UMI was observed in 9.4% of the study cohort.
  • The risk of UMI was notably higher in men (13.1%) compared to women (3.7%).
  • Multivariable analysis identified male gender, increasing age, smoking history, prior stroke, and abdominal aortic aneurysm as significant determinants of UMI.

Conclusions:

  • Unrecognised myocardial infarction is a common finding in cardiac asymptomatic individuals with high vascular risk.
  • The likelihood of UMI escalates with an increasing number of vascular risk factors, underscoring the importance of comprehensive risk assessment.
Abstract

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