Prevalence and prognosis of unrecognized myocardial infarction determined by cardiac magnetic resonance in older adults.
Cast your vote
You can rate an item by clicking the amount of stars they wish to award to this item.
When enough users have cast their vote on this item, the average rating will also be shown.
Your vote was cast
Thank you for your feedback
Thank you for your feedback
AuthorsSchelbert, Erik B
Cao, Jie J
Aletras, Anthony H
Dyke, Christopher K
Launer, Lenore J
Harris, Tamara B
Arai, Andrew E
MetadataShow full item record
CitationJAMA 2012, 308(9):890-6
AbstractUnrecognized myocardial infarction (MI) is prognostically important. Electrocardiography (ECG) has limited sensitivity for detecting unrecognized MI (UMI). Determine prevalence and mortality risk for UMI detected by cardiac magnetic resonance (CMR) imaging or ECG among older individuals. ICELAND MI is a cohort substudy of the Age, Gene/Environment Susceptibility-Reykjavik Study (enrollment January 2004-January 2007) using ECG or CMR to detect UMI. From a community-dwelling cohort of older individuals in Iceland, data for 936 participants aged 67 to 93 years were analyzed, including 670 who were randomly selected and 266 with diabetes. Prevalence and mortality of MI through September 1, 2011. Results reported with 95% confidence limits and net reclassification improvement (NRI). Of 936 participants, 91 had recognized MI (RMI) (9.7%; 95% CI, 8% to 12%), and 157 had UMI detected by CMR (17%; 95% CI, 14% to 19%), which was more prevalent than the 46 UMI detected by ECG (5%; 95% CI, 4% to 6%; P < .001). Participants with diabetes (n = 337) had more UMI detected by CMR than by ECG (n = 72; 21%; 95% CI, 17% to 26%, vs n = 15; 4%; 95% CI, 2% to 7%; P < .001). Unrecognized MI by CMR was associated with atherosclerosis risk factors, coronary calcium, coronary revascularization, and peripheral vascular disease. Over a median of 6.4 years, 30 of 91 participants (33%; 95% CI, 23% to 43%) with RMI died, and 44 of 157 participants (28%; 95% CI, 21% to 35%) with UMI died, both higher rates than the 119 of 688 participants (17%; 95% CI, 15% to 20%) with no MI who died. Unrecognized MI by CMR improved risk stratification for mortality over RMI (NRI, 0.34; 95% CI, 0.16 to 0.53). Adjusting for age, sex, diabetes, and RMI, UMI by CMR remained associated with mortality (hazard ratio [HR], 1.45; 95% CI, 1.02 to 2.06, absolute risk increase [ARI], 8%) and significantly improved risk stratification for mortality (NRI, 0.16; 95% CI, 0.01 to 0.31), but UMI by ECG did not (HR, 0.88; 95% CI, 0.45 to 1.73; ARI, -2%; NRI, -0.05; 95% CI, -0.17 to 0.05). Compared with those with RMI, participants with UMI by CMR used cardiac medications such as statins less often (36%; 95% CI, 28% to 43%, or 56/157, vs 73%; 95% CI, 63% to 82%, or 66/91; P < .001). In a community-based cohort of older individuals, the prevalence of UMI by CMR was higher than the prevalence of RMI and was associated with increased mortality risk. In contrast, UMI by ECG prevalence was lower than that of RMI and was not associated with increased mortality risk.
DescriptionTo access publisher's full text version of this article. Please click on the hyperlink in Additional Links field.
RightsArchived with thanks to JAMA : the journal of the American Medical Association
- Association of Unrecognized Myocardial Infarction With Long-term Outcomes in Community-Dwelling Older Adults: The ICELAND MI Study.
- Authors: Acharya T, Aspelund T, Jonasson TF, Schelbert EB, Cao JJ, Sathya B, Dyke CK, Aletras AH, Sigurdsson S, Thorgeirsson G, Eiriksdottir G, Harris T, Launer LJ, Gudnason V, Arai AE
- Issue date: 2018 Nov 1
- Imaging of Clinically Unrecognized Myocardial Fibrosis in Patients With Suspected Coronary Artery Disease.
- Authors: Antiochos P, Ge Y, Steel K, Bingham S, Abdullah S, Mikolich JR, Arai AE, Bandettini WP, Patel AR, Farzaneh-Far A, Heitner JF, Shenoy C, Leung SW, Gonzalez JA, Shah DJ, Raman SV, Ferrari VA, Schulz-Menger J, Stuber M, Simonetti OP, Kwong RY, SPINS Study Investigators.
- Issue date: 2020 Aug 25
- Midlife Cardiovascular Risk Factors and Late-Life Unrecognized and Recognized Myocardial Infarction Detect by Cardiac Magnetic Resonance: ICELAND-MI, the AGES-Reykjavik Study.
- Authors: McAreavey D, Vidal JS, Aspelund T, Eiriksdottir G, Schelbert EB, Kjartansson O, Cao JJ, Thorgeirsson G, Sigurdsson S, Garcia M, Harris TB, Launer LJ, Gudnason V, Arai AE
- Issue date: 2016 Feb 12
- Long-term prognosis of unrecognized myocardial infarction detected with cardiovascular magnetic resonance in an elderly population.
- Authors: Barbier CE, Themudo R, Bjerner T, Johansson L, Lind L, Ahlström H
- Issue date: 2016 Jul 19
- Prognosis of unrecognised myocardial infarction determined by electrocardiography or cardiac magnetic resonance imaging: systematic review and meta-analysis.
- Authors: Yang Y, Li W, Zhu H, Pan XF, Hu Y, Arnott C, Mai W, Cai X, Huang Y
- Issue date: 2020 May 7