Silent myocardial infarction linked to heart failure risk
Waqas T. Qureshi, M.D., from the Wake Forest School of Medicine in Winston-Salem, N.C., and colleagues examined the correlation of SMI and clinically manifested myocardial infarction (CMI) with heart failure in an analysis of 9,243 participants from the Atherosclerosis Risk in Communities (ARIC) study. Participants were free of cardiovascular disease at baseline (ARIC visit 1: 1987 to 1989).
The researchers found that 305 SMIs and 331 CMIs occurred between ARIC visits 1 and 4 (1996 to 1998). A total of 976 heart failure events occurred after ARIC visit 4 and during a median follow-up of 13 years. Compared to those without MI, participants with CMI and SMI had an increased incidence rate of heart failure (incidence rates per 1,000 person-years, 30.4, 16.2, and 7.8, respectively). Both SMI and CMI were correlated with increased risk of heart failure compared with no MI in a model adjusted for demographics and heart failure risk factors (hazard ratios, 1.35 and 2.85, respectively); these associations were consistent in subgroups stratified by heart failure risk predictors.
"Future research is needed to examine the cost-effectiveness of screening for SMI as part of heart failure risk assessment, and to identify preventive therapies to improve the risk of heart failure among patients with SMI," the authors write.
One author disclosed financial ties to the pharmaceutical and medical device industries.
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