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Post-Myocardial Infarction Heart Failure in Closed-chest Coronary Occlusion/Reperfusion Model in Göttingen Minipigs and Landrace Pigs
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Silent Myocardial Infarction and Long-Term Risk of Heart Failure: The ARIC Study

Waqas T Qureshi1, Zhu-Ming Zhang2, Patricia P Chang3

  • 1Department of Internal Medicine, Section on Cardiology, Wake Forest School of Medicine, Winston Salem, North Carolina.

Journal of the American College of Cardiology
|January 6, 2018
PubMed

Insights

Silent myocardial infarction (SMI) increases heart failure (HF) risk, similar to clinically manifested myocardial infarction (CMI). Early detection and preventive therapies for SMI are crucial for HF risk assessment.

Area of Science:

  • Cardiology
  • Public Health
  • Epidemiology

Background:

  • Silent myocardial infarction (SMI) constitutes approximately 50% of all myocardial infarctions (MIs).
  • The association between SMI and the subsequent risk of heart failure (HF) remains incompletely understood.
  • Understanding SMI's impact on HF is critical for comprehensive cardiovascular risk management.

Purpose of the Study:

  • To investigate the association between SMI and clinically manifested myocardial infarction (CMI) with the risk of developing heart failure (HF).
  • To compare the HF risk in patients with SMI and CMI against individuals with no history of MI.

Main Methods:

  • Analysis of 9,243 participants from the Atherosclerosis Risk In Communities (ARIC) study, initially free of cardiovascular disease.
  • SMI defined by electrocardiographic evidence without clinical symptoms between baseline and ARIC visit 4.
  • Ascertainment of HF events from ARIC visit 4 until 2010, with a median follow-up of 13.0 years.

Main Results:

  • Both SMI and CMI were associated with a significantly higher incidence rate of HF compared to no MI (16.2 and 30.4 vs. 7.8 per 1,000 person-years, respectively).
  • Adjusted analyses revealed SMI (HR: 1.35) and CMI (HR: 2.85) independently increased HF risk.
  • The association between SMI and HF risk was more pronounced in younger individuals (<53 years).

Conclusions:

  • Silent myocardial infarction (SMI) is a significant independent risk factor for heart failure (HF).
  • Further research should explore the cost-effectiveness of screening for SMI in HF risk assessments.
  • Identifying targeted preventive therapies for patients with SMI is essential to mitigate HF risk.
Abstract

Keywords:
electrocardiogramheart failuresilent myocardial infarction

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