ABSTRACT
PURPOSE: To verify the prognostic value of silent myocardial ischemia (SMI) after an uncomplicated myocardial infarction (MI). METHODS: Forty asymptomatic patients were studied after a first uncomplicated MI. They were submitted to 48 hour ambulatory electrocardiographic monitoring and exercise-testing, during the 2nd and 8th weeks after the acute event. Thirty-nine patients were submitted to cardiac catheterization and coronary arteriography; one patient was submitted to necropsy. The electrocardiographic study identified 11 (27.5%) individuals with SMI (group A); the other 29 patients were considered group B. RESULTS: Groups A and B were similar in relation to clinical characteristics, infarct site and ventricular function. Group A had significantly more extensive coronary artery disease when compared to group B. After a two-year follow-up, patients from group A had significantly more coronary events (36.3%) when compared to group B (3.4%). Kaplan-Meier analysis demonstrated a significantly higher cumulative probability of not experiencing a new coronary event for the group B patients. CONCLUSION: SMI may have a prognostic value after uncomplicated MI, as in other clinical manifestations of coronary artery disease.
Subject(s)
Myocardial Infarction/diagnosis , Myocardial Ischemia/diagnosis , Adult , Aged , Brazil/epidemiology , Female , Follow-Up Studies , Humans , Incidence , Male , Middle Aged , Myocardial Infarction/complications , Myocardial Infarction/epidemiology , Myocardial Infarction/mortality , Myocardial Ischemia/epidemiology , Myocardial Ischemia/etiology , Myocardial Ischemia/mortality , Prognosis , Risk FactorsSubject(s)
Aged , Cineangiography , Coronary Disease/diagnosis , Female , Humans , Male , Sex FactorsABSTRACT
Foi estudada a cinecoronarioventriculografia de 167 pacientes com idade superior a 70 anos de portadores de angina instavel, sendo 131 do sexo masculino. Registrou-se a localizacao o numero e grau das lesoes obstrutivas das arterias coronarias, a presenca de circulacao colateral e a alteracao da contracao do ventriculo esquerdo. Os pacientes foram divididos em: grupo A - portadores de arterias coronarias normais ou com obstrucao ate 50% (27); grupo B - portadores de lesao uniarterial com obstrucao superior a 50% (36); grupo C - portadores de lesao biarterial com obstrucao superior a 50% (52) e grupo D - portadores de lesao triarterial com obstrucao superior a 50% (52). Observou-se que em 11,4% dos casos, as arterias coronarias eram normais. Entre os pacientes com menor comprometimento coronario (grupos A e B), a frequencia de mulheres foi significativamente maior que entre os doentes com comprometimento mais acentuado (grupo C e D). A descendente anterior foi a arteria mais frequentemente alterada. A presenca de circulacao colateral acompanhou a gravidade do comprometimento coronario. O comprometimento ventricular esquerdo foi concordante com a intensidade das alteracoes coronarias