Prognostic Indicators of Major Cardiac Events in Patients with Asymptomatic Coronary Artery Disease.
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- KISHIDA Hiroshi
- First Department of Internal Medicine, Nippon Medical School
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- SAITOH Tsutomu
- First Department of Internal Medicine, Nippon Medical School
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- SANO Junko
- First Department of Internal Medicine, Nippon Medical School
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- TADA Yumiko
- First Department of Internal Medicine, Nippon Medical School
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- HANASHI Aya
- First Department of Internal Medicine, Nippon Medical School
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- FUKUMA Nagaharu
- First Department of Internal Medicine, Nippon Medical School
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- TSUKADA Yayoi
- First Department of Internal Medicine, Nippon Medical School
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- SEKIDO Morihisa
- First Department of Internal Medicine, Nippon Medical School
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- HOMMA Hiroshi
- First Department of Internal Medicine, Nippon Medical School
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- MIYATAKE Yoshiko
- First Department of Internal Medicine, Nippon Medical School
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- TOMITA Yoshibumi
- First Department of Internal Medicine, Nippon Medical School
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- KUSAMA Yoshiki
- First Department of Internal Medicine, Nippon Medical School
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We investigated the role of myocardial ischemia in acute myocardial infarction and cardiac death in 253 patients with asymptomatic coronary disease (206 men, 47 women, mean age: 55±8 years). Patients were divided into two groups: those with angina pectoris with no history of myocardial infarction (AP group, 93 patients) and those with a history of myocardial infarction (MI group, 160 patients). We also examined the usefulness of exercise electrocardiographic and Holter electrocardiographic findings as prognostic indicators of cardiac events. After 24-hour Holter electrocardiograms were obtained in both groups, patients were assigned to subgroups with or without silent myocardial ischemia (SMI) based on the presence or absence of transient ST-segment depression. Prognostic indicators were evaluated by multiple regression analysis. Cardiac events occurred in 26 (10.3%) of 253 patients; in 6 patients these events were fatal. The incidence of cardiac events was significantly higher in the SMI group than in the non-SMI group (16.4% versus 5.6%, p<0.05). SMI was identified as a significant prognostic indicator in the overall population (p=0.0088), as were the number of diseased coronary arteries in the AP group (p=0.0152), and SMI (p=0.0022) in the MI group. There were 3 deaths related to cardiac events in each group. The mean time from onset of angina pectoris to death was 73±41 months compared with 33±43 months in the MI group. Our findings suggest that the severity of the coronary lesion and SMI were important predictors of major cardiac events, and that the mechanism of the onset of cardiac events was different in the AP and MI groups.
収録刊行物
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- Japanese Heart Journal
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Japanese Heart Journal 37 (1), 59-72, 1996
International Heart Journal刊行会