Kannel W B, Abbott R D
N Engl J Med. 1984 Nov 1;311(18):1144-7. doi: 10.1056/NEJM198411013111802.
Of 708 myocardial infarctions among 5127 participants in the Framingham Study, more than 25 per cent were discovered only through the appearance of new diagnostic evidence during routine biennial electrocardiographic examinations. Of these unrecognized infarctions almost half were "silent," and the others caused atypical symptoms. The proportion of all infarcts that were unrecognized was higher in women and in older men. Such infarcts were uncommon in persons with angina. Unrecognized infarctions were as likely as recognized ones to cause death, heart failure, or strokes. Recurrent infarctions were more common in women with recognized than with unrecognized infarcts, but this difference was not present in men. Recurrent infarctions were more likely to be recognized than were first infarctions. We conclude that unrecognized infarctions are common and have as serious a prognosis as recognized infarctions.
在弗雷明汉姆研究的5127名参与者中发生了708例心肌梗死，其中超过25%是在每两年一次的常规心电图检查中通过新的诊断证据才被发现的。在这些未被识别的梗死中，几乎一半是“无症状的”，其他则表现为非典型症状。未被识别的梗死在女性和老年男性中所占的比例更高。此类梗死在心绞痛患者中并不常见。未被识别的梗死与已被识别的梗死导致死亡、心力衰竭或中风的可能性相同。复发性梗死在已被识别梗死的女性中比在未被识别梗死的女性中更常见，但在男性中不存在这种差异。复发性梗死比首次梗死更有可能被识别出来。我们得出结论，未被识别的梗死很常见，其预后与已被识别的梗死一样严重。
