![]() ![]() Previous cohort studies show conflicting results with regard to long-term prognosis of these silent or unrecognized MIs compared with that of recognized MIs. Silent MI might even be more prevalent, since the reported prevalences are based on the occurrence of pathological Q-waves in the electrocardiogram (ECG) thus omitting the probably substantial percentage of MIs that does not (or only briefly) display Q-waves in the ECG. In fact, previous studies 1–13 have shown that 20–43% of all MIs are not diagnosed-either because there are no symptoms (silent MI) or because the symptoms are so mild or diffuse that neither patient nor doctor consider the diagnosis. ![]() Myocardial infarction (MI) is not always associated with classical chest pain. Myocardial infarction, Silent myocardial infarction, Unrecognized myocardial infarction, Q-waves, Cohort study Introduction Conversely, there was no difference in the outcome of patients with anteriorly HR 1.6 (95%CI: 1.1–2.4) vs. Minnesota code 1.2.x-1.3.x) were associated with a poor prognosis, hazard ratio (HR) 1.4, though not as grave as large Q-waves (i.e. Persons with hypertension, diabetes, and impaired renal function were more likely to have Q-waves. ![]() One hundred and fourteen (2.1%) had pathological Q-waves, of whom 44% suffered from an event compared with 18% from the control group, P< 0.001. During a median of 7.8 years of follow-up, 1003 persons reached the combined endpoint. Multivariate Cox proportional hazards regression models were used to examine the associations of Q-waves adjusted for age, hypertension, diabetes, and estimated glomerular filtration rate with the risk of the combined endpoint of death and hospitalization for IHD. Electrocardiograms (ECGs) of 5381 persons without known IHD or HF from the 4th Copenhagen City Heart Study were reviewed and Q-waves were classified according to their size and location. ![]()
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