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Post-Myocardial Infarction Heart Failure in Closed-chest Coronary Occlusion/Reperfusion Model in Göttingen Minipigs and Landrace Pigs
Published on: April 17, 2021
Silent myocardial infarction and risk of heart failure: Current evidence and gaps in knowledge
1Epidemiological Cardiology Research Center (EPICARE), Department of Epidemiology and Prevention, and Department of Medicine, Section on Cardiology, Wake Forest School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157, United States.
Insights
Silent myocardial infarction (SMI) significantly increases heart failure (HF) risk. Understanding this link is crucial for managing coronary heart disease (CHD) and preventing heart failure hospitalizations.
Area of Science:
- Cardiology
- Public Health
Background:
- Coronary heart disease (CHD) is a primary risk factor for heart failure (HF).
- Myocardial infarction (MI) history is present in up to one-third of HF hospitalizations.
- Silent myocardial infarction (SMI) may account for half of all MIs, yet its link to HF is understudied.
Purpose of the Study:
- To review and discuss current evidence on the association between SMI and HF risk.
- To analyze how different definitions of SMI affect reported associations with HF.
- To explore potential mechanisms, implications, and knowledge gaps regarding SMI and HF.
Main Methods:
- Literature review and synthesis of existing studies.
- Analysis of heterogeneity in SMI definitions and its impact.
- Discussion of potential biological and clinical pathways.
Main Results:
- Existing studies consistently show SMI is linked to increased HF risk.
- Magnitude of risk and sex differences vary, likely due to diverse SMI definitions.
- Further research is needed to clarify these associations and their underlying mechanisms.
Conclusions:
- SMI is a significant, often unrecognized, contributor to heart failure development.
- Standardized definitions of SMI are needed for clearer risk assessment.
- Addressing SMI is critical for comprehensive cardiovascular disease management.
Abstract:
Coronary heart disease (CHD) is the most common underlying risk factor for heart failure (HF); up to one-third of the patients who are hospitalized for HF each year in the United States have a history of myocardial infarction (MI). Although silent MI (SMI) could account for up to one-half of all MIs, only a few studies examined the relationship between SMI and risk of HF. These few studies agreed on their conclusions that SMI is associated with increased risk of HF. However, there was less agreement on the magnitude of risk and the sex differences in the association between SMI and HF, which is probably due to the heterogeneity in how these studies defined SMI. This report summarizes and discusses the current evidence linking SMI to HF, the impact of the methods by which SMI is defined on the reported relationship between SMI and HF, the potential mechanisms for such relationship, the implications of these findings, and the gaps in knowledge that need to be addressed.
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