ABSTRACT
Repeated annual 24-hour Holter's ECG monitoring sessions were used as a basis for 4-year follow-up of 108 male coronary patients with episodes of painless myocardial ischemia in the course of their everyday routines, and 144 control patients showing no signs of transient asymptomatic ischemia at 24-hour Holter's ECG monitoring. Four years of follow-up demonstrated no differences between the two groups, compared with respect to the incidence of myocardial infarction and associated mortality as well as aggravations of coronary heart disease, in terms of clinical pattern of the disease, the incidence of acute coronary episodes and survival rates. There were no sudden deaths in either of the groups. Transient painless myocardial ischemic episodes are shown to carry no additional risk of myocardial infarction and sudden death in elderly coronary patients with occasional anginal attacks.
Subject(s)
Angina Pectoris/diagnosis , Cardiac Complexes, Premature/diagnosis , Coronary Disease/diagnosis , Aged , Angina Pectoris/mortality , Cardiac Complexes, Premature/mortality , Coronary Disease/mortality , Electrocardiography , Follow-Up Studies , Humans , Male , Middle Aged , Monitoring, Physiologic , Physical Exertion , Prognosis , Prospective StudiesABSTRACT
Five hundred and seventy coronary patients of both sexes, showing occasional attacks of angina of effort, were subjected to 24-hour ECG monitoring sessions at 1 week intervals during 1 month. Ischemic episodes were detected in 139 (24%) patients. A total of 362 ischemic episodes were already detected at the first ECG monitoring session, the majority of those (97%) being painless. Magnitude and duration of ST depression were similar in the absence of pain and during anginal attacks. Repeated sessions demonstrated considerable spontaneous variability in the frequency of ischemic episodes.
