Silent Heart Attack Linked to Heart Failure Risk

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Silent and clinically manifested MI both correlated with future risk of heart failure in adjusted models.
Silent and clinically manifested MI both correlated with future risk of heart failure in adjusted models.

(HealthDay News) -- Silent myocardial infarction (SMI) is associated with an increased long-term risk of heart failure, according to a study published in the Journal of the American College of Cardiology.

Waqas T. Qureshi, MD, from the Wake Forest School of Medicine in Winston-Salem, North Carolina, and colleagues examined the correlation of SMI and clinically manifested myocardial infarction (CMI) with heart failure in an analysis of 9243 participants from the Atherosclerosis Risk in Communities (ARIC) study. Participants were free of cardiovascular disease at baseline (ARIC visit 1: 1987 to 1989).

The researchers found that 305 SMIs and 331 CMIs occurred between ARIC visits 1 and 4 (1996 to 1998). A total of 976 heart failure events occurred after ARIC visit 4 and during a median follow-up of 13 years. Compared to those without MI, participants with CMI and SMI had an increased incidence rate of heart failure (incidence rates per 1000 person-years, 30.4, 16.2, and 7.8, respectively). Both SMI and CMI were correlated with increased risk of heart failure compared with no MI in a model adjusted for demographics and heart failure risk factors (hazard ratios, 1.35 and 2.85, respectively); these associations were consistent in subgroups stratified by heart failure risk predictors.

"Future research is needed to examine the cost-effectiveness of screening for SMI as part of heart failure risk assessment, and to identify preventive therapies to improve the risk of heart failure among patients with SMI," the authors write.

One author disclosed financial ties to the pharmaceutical and medical device industries.

References

Qureshi WT, Zhang ZM, Chang PP, Rosamond WD, Kitzman DW, Wagenknecht LE and Soliman EZ. Silent Myocardial Infarction and Long-Term Risk of Heart Failure: The ARIC Study. JACC January 2018;71:1. doi:10.1016/j.jacc.2017.10.071

Gibson CM, Nafee T, and Kerneis M. Silent Myocardial Infarction Listen to the Evidence. JACC January 2018;71:1. doi:10.1016/j.jacc.2017.10.069

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