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      Silent Myocardial Ischemia during Exercise Testing: Does it Indicate a Different Angiographic and Prognostic Syndrome?

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          Abstract

          The prognostic significance of silent myocardial ischemia detected during graded exercise testing (GXT) is uncertain. The angiographic characteristics and long-term follow-up of 83 patients with silent ischemia (group 1), mean age 58 ± 9 years, were compared with 83 age- and sex-matched patients with typical angina pectoris (group 2). Basic characteristics and mean follow-up (42 ± 22 months) were similar in both groups. Patients with silent ischemia were characterized by longer duration of exercise test (6.5 vs. 4.8 min, p < 0.01), larger extent of maximum ST depression during peak exercise (2.4 vs. 2.0 mm, p < 0.01) and higher maximal double product at peak exercise (24,650 vs. 20,825, p < 0.01) compared to group 2. Long-term follow-up revealed similar rates of mortality (3.6 vs. 4.8%, p = NS) and major cardiac events (19.3 vs. 21.7%, p = NS). However, patients with typical angina tended to have more revascularization procedures (81 vs. 61 %, p < 0.1). Thus, patients with silent ischemia have a better GXT capacity compared to patients with typical angina pectoris. Despite a similar severity of coronary involvement, patients with typical angina pectoris tend to have more revascularization procedures, yet the long-term prognosis appears similar.

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          Author and article information

          Journal
          CRD
          Cardiology
          10.1159/issn.0008-6312
          Cardiology
          S. Karger AG
          0008-6312
          1421-9751
          1994
          1994
          18 November 2008
          : 85
          : 6
          : 407-414
          Affiliations
          aDepartment of Cardiology and bSchool of Public Health and Community Medicine, Hadassah University Hospital, Jerusalem, Israel
          Article
          176742 Cardiology 1994;85:407–414
          10.1159/000176742
          7697676
          © 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: 8
          Categories
          Diagnostic and Noninvasive Cardiology

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