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06-06-2010 | Cardiology | Article

Unrecognized MI linked to increased risk for HF in men


Free abstract

MedWire News: Unrecognized myocardial infarction (MI) as detected by electrocardiography (ECG) is associated with as great a risk for heart failure (HF) long-term in men as is recognized MI, according to a Dutch study.

The research found no significant relationship between unrecognized MI and HF risk in women, however.

A team from the Erasmus Medical Center in Rotterdam, The Netherlands, examined ECG data at baseline for 2581 men and 3724 women aged 55 years or older who participated in The Rotterdam Study.

A total of 832 cases of HF occurred during follow-up lasting a median of 13.2 years. For men, the cumulative incidences of HF were 17% with no MI, 37% with unrecognized MI (participants without documented or self-reported MI but with ECG characteristics matching MI), and 39% with recognized MI.

For women, the corresponding cumulative incidences of HF were 11%, 13%, and 28%.

Analysis showed that, in men, recognized MI and unrecognized MI were independently associated with 2.6-fold and 2.1-fold increased risks for developing HF, respectively.

In women, by contrast, only recognized, and not unrecognized, MI was associated with increased risk for HF after adjusting for cardiovascular risk factors, at respective hazard ratios of 2.8 and 1.1.

Reporting their findings in the journal Heart, Jacqueline Witteman and co-authors say the results underline “the importance of enhanced alertness for typical and atypical symptoms of MI by both doctors and patients.”

They add: “The inability to show an association between unrecognized MI in women and incident HF adds to the existing suggestion that women are more prone to misclassification of unrecognized MI based on ECG.”

MedWire ( is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

By Caroline Price

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