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      Prognostic Implications of Asymptomatic Cardiac Ischemia

      ,

      Cardiology

      S. Karger AG

      Asymptomatic cardiac ischemia, Coronary artery disease, Angiography

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          Abstract

          The Oslo Ischemia Study was initiated between 1972 and 1975 in 2,014 men (age, 40-59 years), with the aim of detecting previously unknown and unsuspected coronary heart disease. Of the men who were eligible, 86% participated and were apparently free from cardiovascular disorders. Following a positive symptom-limiting bicycle test, 109 of the men underwent diagnostic coronary angiography and 105 were evaluable; the angiograms were normal in 36 and pathologic in 69. Nineteen of the men with pathologic angiograms had mild angina on the exercise test, while 50 (72%; 2.5% of total study population) remained completely asymptomatic. During a mean follow up of 15 years, 14 of the 50 completely asymptomatic men died (12 suddenly, 1 of whom had angina pectoris for 5 years). Eighteen of the surviving 36 men remained completely asymptomatic and free from signs of coronary artery disease, other than exercise-induced ST-segment depression. One man had ECG signs of a previous myocardial infarction, on the annual follow up; chest pain as a first presenting symptom was observed in a further 17 of 36 survivors. Repeat angiography was performed in 22 men who experienced either chest pain or worsening symptoms following exercise test; of these, 14 underwent coronary bypass surgery and are still alive. The data appear to refute a ‘wait-and-see’ policy among subjects with asymptomatic cardiac ischemia. It is concluded that medical or surgical intervention can affect prognosis in the asymptomatic or mildly symptomatic phase of coronary artery disease. Further trials are in progress to evaluate if prognosis can be improved by effective anti-ischemic intervention.

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          Author and article information

          Journal
          CRD
          Cardiology
          10.1159/issn.0008-6312
          Cardiology
          S. Karger AG
          978-3-8055-6092-4
          978-3-318-01938-4
          0008-6312
          1421-9751
          1994
          1994
          19 November 2008
          : 85
          : Suppl 2
          : 11-15
          Affiliations
          University Hospital Oslo, Rikshospitalet, Oslo, Norway
          Article
          177042 Cardiology 1994;85:11–15
          10.1159/000177042
          7736482
          © 1994 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

          Page count
          Pages: 5
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          Paper

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