Prevalence, determinants, and misclassification of myocardial infarction in the elderly

被引:52
作者
deBruyne, MC
Mosterd, A
Hoes, AW
Kors, JA
Kruijssen, DACM
vanBemmel, JH
Hofman, A
Grobbee, DE
机构
[1] ERASMUS UNIV ROTTERDAM, SCH MED, DEPT MED INFORMAT, NL-3000 DR ROTTERDAM, NETHERLANDS
[2] ERASMUS UNIV ROTTERDAM, SCH MED, DEPT GEN PRACTICE, NL-3000 DR ROTTERDAM, NETHERLANDS
[3] ACAD HOSP ROTTERDAM DIJKZIGT, CTR THORAX, DEPT CARDIOL, NL-3000 DR ROTTERDAM, NETHERLANDS
[4] UNIV UTRECHT, JULIUS CTR PATIENT ORIENTED RES, SCH MED, UTRECHT, NETHERLANDS
关键词
aged; cohort study; myocardial infarction; prevalence;
D O I
10.1097/00001648-199709000-00004
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
We evaluated the prevalence, determinants, and misclassification of different types of myocardial infarction in 3,272 men and women age 55 years or older. We defined self-reported myocardial infarction with electrocardiographic evidence as ''typical myocardial infarction.'' We defined self-reported myocardial infarction without electrocardiographic evidence, but verified with additional clinical information, as ''non-Q-wave myocardial infarction.'' Finally, we defined myocardial infarction detected by electrocardiogram that was not self-reported as ''silent myocardial infarction,'' after verification of absence of symptoms. Overall, the prevalence of typical myocardial infarction was 4.1% [95% confidence interval (CI) = 3.5-4.9], of non-Q-wave myocardial infarction 2.8% (95% CI = 2.2-3.4), and of silent myocardial infarction 3.9% (95% CI = 3.2-4.5). Silent myocardial infarction was more prevalent in women, hypertensives, cigarette smokers, and those with higher post-load blood glucose. Self-reported myocardial infarction without electrocardiographic characteristics could be verified as myocardial infarction by means of additional clinical information in 56% of the cases. We conclude that myocardial infarction occurs frequently in the elderly without typical symptoms or electrocardiographic changes. As all these manifestations of myocardial infarction convey an increased risk of symptomatic heart disease or death, they require further attention. Misclassification due to limited sources of information can be considerable and should be taken into account in the design and interpretation of epidemiologic studies.
引用
收藏
页码:495 / 500
页数:6
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