Exercise-induced silent myocardial ischemia and coronary morbidity and mortality in middle-aged men

Laukkanen, Jari A.; Kurl, Sudhir; Lakka, Timo A.; Tuomainen, Tomi‐Pekka; Rauramaa, Rainer; Salonen, Riitta; Eränen, Jaakko; Salonen, Jukka T.

doi:10.1016/s0735-1097(01)01311-0

Cited by 112 publications

(86 citation statements)

References 37 publications

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“…Other studies have shown the presence of silent ischemia to be predictive of the advent of angina rather than death or MI 19 and that the coexistence of at least one conventional risk factor in addition to ST depression substantially increases the relative risk of coronary events. 86 …”

Section: Cohn Et Al Silent Myocardial Ischemiamentioning

confidence: 99%

Silent Myocardial Ischemia

2003

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Section: Cohn Et Al Silent Myocardial Ischemiamentioning

confidence: 99%

Silent Myocardial Ischemia

2003

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“…This observation was made by using a maximal symptom-limited E-ECG stress test in 1769 middle-aged men. 9 In a previous article, our group also showed the usefulness of E-ECG for predicting CHD in patients with DM. We observed 2854 men with DM who completed a maximal E-ECG test and were without a previous CVD event at baseline.…”

Section: Discussionmentioning

confidence: 87%

“…Our results concerning the positive association between abnormal E-ECG results and a higher risk of CHD mortality are in unison with other population-based studies of asymptomatic men with other CVD risk factors. 9,[20][21][22] The Framingham Heart Study-Offspring found that ST-segment depression provided additional prognostic information in age-and Framingham risk score-adjusted models in men, particularly among those in the highest-risk group (10-year predicted CHD risk of ≥20%). 20 This study evaluated 3043 asymptomatic men and women, who underwent a symptom-limited E-ECG test and were followed up for 18.2 years.…”

Section: Discussionmentioning

confidence: 99%

“…Their results suggest that the SRI predicts all-cause mortality in hypertensive individuals with angina and may potentially provide important prognostic information in replacement of other clinical and standard exercise testing data. 10 Laukkanen et al 9 showed results that exercise-induced silent ischemia was associated with adverse outcomes in persons who were at high risk of developing CHD because of smoking, hypercholesterolemia, or hypertension. This observation was made by using a maximal symptom-limited E-ECG stress test in 1769 middle-aged men.…”

Section: Discussionmentioning

confidence: 99%

“…Ekelund et al 8 reported that positive findings on E-ECG was an independent predictor of CVD events in men with hypercholesterolemia. Laukkanen et al 9 reported that exercise-induced ischemia was associated with a higher risk of adverse outcomes in persons at high risk of CHD. Bigi et al 10 suggested that the stress-recovery index (SRI) predicts all-cause mortality in persons with hypertension.…”

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confidence: 99%

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Maximal Exercise Electrocardiographic Responses and Coronary Heart Disease Mortality Among Men With Metabolic Syndrome

Lyerly

Sui²,

Church

et al. 2010

Mayo Clinic Proceedings

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Objective: To examine the association between abnormal exercise electrocardiographic (E-ECG) test results and mortality (all-cause and that resulting from coronary heart disease [CHD] or cardiovascular disease [CVD]) in a large population of asymptomatic men with metabolic syndrome (MetS).patients and MethOds: A total of 9191 men (mean age, 46.9 years) met the criteria of having MetS. All completed a maximal E-ECG treadmill test (May 14, 1979, through April 9, 2001) and were without a previous CVD event or diabetes at baseline. Main outcomes were all-cause mortality, mortality due to CHD, and mortality due to CVD. Cox regression analysis was used to quantify the mortality risk according to E-ECG responses.Results: During a follow-up of 14 years, 633 deaths (242 CVD and 150 CHD) were identified. Mortality rates and hazard ratios (HRs) across E-ECG responses were the following: for all-cause mortality: HR, 1.36; 95% confidence interval (CI), 1.09-1.70 for equivocal responses and HR, 1.41; 95% CI, 1.12-1.77 for abnormal responses (P trend <.001); for mortality due to CVD: HR, 1.29; 95% CI, 0.88-1.88 for equivocal responses and HR, 2.04; 95% CI, 1.46-2.84 for abnormal responses (P trend <.001); and for mortality due to CHD: HR, 1.62; 95% CI, 1.02-2.56 for equivocal responses and HR, 2.45; 95% CI, 1.62-3.69 for abnormal responses (P trend <.001). A positive gradient for CHD, CVD, and all-cause mortality rates across E-ECG categories within 3, 4, or 5 MetS components was observed (P<.001 for all).cOnclusiOn: Among men with MetS, an abnormal E-ECG response was associated with higher risk of all-cause, CVD, and CHD mortality. These findings underscore the importance of E-ECG tests to identify men with MetS who are at risk of dying. Proc. 2010;85(3):239-246 ACLS = Aerobics Center Longitudinal Study; CHD = coronary heart disease; CI = confidence interval; CRF = cardiorespiratory fitness; CVD = cardiovascular disease; DM = diabetes mellitus; ECG = electrocardiography; E-ECG = exercise ECG; HR = hazard ratio; MET = metabolic equivalent; MetS = metabolic syndrome; NDI = National Death Index; SRI = stress-recovery index From the department of Kinesiology, school of health, Kinesiology, and sport studies, coastal carolina university, conway, sc (G.W.l.); department of exercise science (G.W.l., X.s., G.a.h., s.n.b.) and department of epidemiology and biostatistics (s.n.b.), arnold school of public health, university of south carolina, columbia; pennington biomedical Research center, baton Rouge, la (t.s.c.); and department of cardiovascular diseases, Ochsner Medical center, new Orleans, la (c.j.l.). the aerobics center longitudinal study was supported by national institutes of health grants aG06945 and hl62508. Mayo Clinindividual reprints of this article are not available. address correspondence to G. William lyerly, phd, department of Kinesiology, school of health, Kinesiology, and sport studies, coastal carolina university, pO box 261954, conway, sc 29528 (glyerly@coastal.edu). © 2010 Mayo Foundation for Medical Education ...

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Dynamics of Silent Ischaemia

Stern¹

2004

Dynamic Electrocardiography

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Exercise-induced silent myocardial ischemia and coronary morbidity and mortality in middle-aged men

Abstract: Exercise-induced silent myocardial ischemia was a strong predictor of CHD in men with any conventional risk factor, emphasizing the importance of exercise testing to identify asymptomatic high risk men who could benefit from risk reduction and preventive measures.

Cited by 112 publications

References 37 publications

Silent Myocardial Ischemia

Silent Myocardial Ischemia

Maximal Exercise Electrocardiographic Responses and Coronary Heart Disease Mortality Among Men With Metabolic Syndrome

Dynamics of Silent Ischaemia

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