There is some evidence that a relatively favorable outcome after SMI compared with clinical MI may be restricted to women. 6 However, other studies have revealed equivalent 4, 5 or even significantly lower 3 rates. 2 – 6 Some have shown that mortality in those with SMI is higher than in those with a previous clinically evident myocardial infarction (MI). Studies that have assessed prognosis in individuals with SMI from the general population have produced variable results. 1 Silent myocardial infarction (SMI), defined as the presence of pathological Q waves in the absence of a history of typical cardiac symptoms, is one of the abnormalities that can be detected through ECG screening. The net reclassification index showed no improvement when SMI was added to these models, and the integrated discrimination index showed that SMI marginally improved the prediction of fatal MI and all-cause mortality.Ī resting 12-lead ECG remains a simple and inexpensive component of recommended routine cardiovascular risk assessment in diabetes mellitus. Hazard ratios for first fatal or nonfatal MI and for first nonfatal MI were nonsignificant. Fully adjusted hazard ratios for those with versus those without SMI in multivariate models that included UKPDS Risk Engine variables were 1.58 (95% confidence interval, 1.22–2.05) for fatal MI and 1.31 (95% confidence interval, 1.10–1.56) for all-cause mortality. Their mean blood pressure was greater despite more intensive antihypertensive treatment they were more likely to be taking aspirin and lipid-lowering therapy and they had a greater prevalence of microangiopathy. Those with SMI were more likely to be older, female, sedentary, and nonsmokers compared with those without SMI. Of 1967 patients with complete baseline data, 326 (16.6%) had ECG evidence of SMI (Minnesota codes 1.1 or 1.2) at enrollment. We examined data from the 5102 patients in the 30-year UK Prospective Diabetes Study (UKPDS) and used Cox proportional hazards regression to examine outcomes by SMI status. Customer Service and Ordering Information.Stroke: Vascular and Interventional Neurology.Journal of the American Heart Association (JAHA).Circ: Cardiovascular Quality & Outcomes.Arteriosclerosis, Thrombosis, and Vascular Biology (ATVB).

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