Clinical and Prognostic Significance of Silent Myocardial Ischemia in Survivors after Acute Myocardial Infarction : PANEL DISCUSSION ON SILENT MYOCARDIAL ISCHEMIA
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概要
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To clarify the clinical and prognostic significance of silent myocardial ischemia (SMI) after acute myocardial infarction (MI), the clinical characteristics and long-term prognosis after discharge in 525 medically treated survivors after acute MI were investigated. According to the presence of post-infarction angina and results of all exercise tests during hospitalization, 309 patients without ischemic episodes were classified into control group, 59 patients with SMI into SMI group and 157 patients with post-infarction angina into AP group. Previous MI (29%, 24%, 11%, respectively), non-Q wave MI (34%, 34%, 15%) and multivessel disease (69%, 61%, 33%) were more frequent in the SMI and AP groups than in the control group. These indicated clinical characteristics in patients with SMI were similar to those in patients with angina pectoris. The incidence of angina prior to MI onset in patients with SMI was lower than in patients with post-infarction angina. This may suggest that there is some common mechanism keeping them silent in the pre- and post-MI period. During the mean follow-up period of 5.5 years, 93 patients died and 78 had a recurrent MI. Cumulative total and cardiac mortality, and incidence of recurrent MI by actuarial method were higher in the SMI as well as AP group than in the control group. There was no statistically significant difference in prognosis between SMI and AP group. We conclude total ischemic burden, not only symptomatic but SMI, should be treated using currently available therapeutic modalities for further improvement of long-term prognosis in survivors after acute MI.
- 社団法人日本循環器学会の論文
- 1989-11-20
著者
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Haze Kazuo
Department Of Cardiology Osaka City General Hospital
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HAZE Kazuo
Cardiac Division, Department of Internal Medicine, National Cardiovascular Center
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HIRAMORI Katsuhiko
Cardiac Division, Department of Internal Medicine, National Cardiovascular Center
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Ueshima Kenji
Cardiac Division Departmet Of Internal Medicine National Cardiovascular Center
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KASAGI FUMIYOSHI
Department of Epidemiology,National Cardiovascular Center
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Hiramori Katsuhiko
Cardiac Division Department Of Internal Medicine National Cardiovascular Center
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FAKAMI KENICHI
Cardiac Division, Department of Internal Medicine, National Cardiovascular Center
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Haze Kazuo
Heart Institute Japan Tokyo Women's Medical College
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Fukami Kenichi
Iwate Medical University
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Fakami Kenichi
Cardiac Division Department Of Internal Medicine National Cardiovascular Center
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Kasagi Fumiyoshi
Department Of Epidemiology Hiroshima Radiation Effect Research Foundation
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Haze Kazuo
Cardiac Division Department Of Internal Medicine National Cardiovascular Center
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Kasanuki Hiroshi
Faculty Of Science And Engineering Waseda University
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