Unzueta-Montoya A, Escobedo-de la Peña J, Torres-y Gutiérrez Rubio A, Unzueta A, Ordoñez-Toquero G, Pérez-Reyes P, Hernández-y Hernández H
Hospital of Cardiology, National Medical Center Siglo XXI, Mexican Institute of the Social Security, Mexico, D.F., Mexico.
Clin Cardiol. 2000 Apr;23(4):248-52. doi: 10.1002/clc.4960230405.
Silent myocardial ischemia is a growing world health problem. It has been related to factors that promote an increase in myocardial oxygen demand or affect coronary vasomotor tone. Coronary artery disease has shown an increasing trend in Mexico in this century.
The aim of the study was to estimate the strength of the association between some risk factors and the occurrence of silent myocardial ischemia.
A cross-sectional study was conducted and 249 individuals were screened by 24-h Holter electrocardiogram. Silent myocardial ischemia was diagnosed in patients with painless transient ST-segment depression. All subjects were interviewed for coronary risk factors and total serum cholesterol was measured.
Silent ischemia was diagnosed in 115 patients (46%), who were older (59 +/- 9 vs. 57 +/- 11 years; p = 0.01). In a logistic regression analysis, a lower risk for silent ischemia was found in patients with thrombolysis [odds ratio (OR) 0.28; 95% confidence interval (CI 95%) 0.14-0.53], or those who followed their medical treatment (OR 0.16; CI 95% 0.04-0.68). The major risk factors were hypercholesterolemia (OR 1.6; CI 95% 0.9-2.9) and more severe coronary artery disease (OR 2.5; CI 95% 1.1-5.7).
Some coronary risk factors are related to silent ischemia. It is still important to diagnose this entity, but modification of its related risk factors should be kept in mind to diminish its occurrence and its severe consequences.
无症状性心肌缺血是一个日益严重的全球健康问题。它与促进心肌需氧量增加或影响冠状动脉血管舒缩张力的因素有关。在本世纪，冠状动脉疾病在墨西哥呈上升趋势。
本研究的目的是评估某些危险因素与无症状性心肌缺血发生之间的关联强度。
进行了一项横断面研究，通过24小时动态心电图对249名个体进行筛查。对无痛性短暂ST段压低的患者诊断为无症状性心肌缺血。所有受试者均接受冠状动脉危险因素访谈，并测量总血清胆固醇。
115例患者（46%）被诊断为无症状性缺血，这些患者年龄较大（59±9岁对57±11岁；p = 0.01）。在逻辑回归分析中，溶栓治疗的患者无症状性缺血风险较低[比值比（OR）0.28；95%置信区间（CI 95%）0.14 - 0.53]，或遵循医嘱治疗的患者（OR 0.16；CI 95% 0.04 - 0.68）。主要危险因素为高胆固醇血症（OR 1.6；CI 95% 0.9 - 2.9）和更严重的冠状动脉疾病（OR 2.5；CI 95% 1.1 - 5.7）。
一些冠状动脉危险因素与无症状性缺血有关。诊断这一实体仍然很重要，但应牢记改变其相关危险因素以减少其发生及其严重后果。
