TY - JOUR
T1 - Relation of patient characteristics to cardiac ischemia during daily life activity (an Asymptomatic Cardiac Ischemia Pilot data bank study)
AU - Pepine, Carl J.
AU - Andrews, Thomas
AU - Deanfield, John E.
AU - Forman, Sandra
AU - Geller, Nancy
AU - Hill, James A.
AU - Pratt, Craig
AU - Rogers, William J.
AU - Sopko, George
AU - Steingart, Richard
AU - Stone, Peter H.
AU - Conti, C. Richard
AU - Knatterud, Genell
N1 - Funding Information:
From the University of Florida, College of Medicine, Division of Cardiology, Gainesville, Florida. This study was funded by research contracts HV-90-07, HV90-08, HV-91-05 to HV-9 1-l 4 from the National Heart, lung, and Blood Institute, Cardiac Diseases Branch, Division of Heart and Vascular Diseases, National Institutes of Health, Bethesda, Maryland Stud medications and placebo were donated by Zeneca Pharmaceutlca Ys Group, Wilmington, Delaware, Marion-Merreil Dow, Kansas City, Missouri, ond Pfizer, New York, New York Support for electrocardiographic data colleciion was provided in part by Applied Cardiac Systems, Loguna Hills, California, Mor-quette Electronics, Milwaukee, and Mortar0 Instrument, Milwaukee, Wisconsin, and Quinton Instruments, Seattle, Wasin ton. Some centers hod partial support from General Clinical Reseorc 9, Center grants. Manuscript received September 25, 1995; revised manuscript received and accepted January 30, 1996.
PY - 1996/6/15
Y1 - 1996/6/15
N2 - Cardiac ischemia during daily life activities, detected by ambulatory electrocardiographic (AECG) monitoring has been associated with increased risk for adverse outcomes. Because daily life ischemia is usually asymptomatic, prevalence and descriptive data of patients with asymptomatic cardiac ischemia (ACI) are not well defined. Accordingly, patients screened for the Asymptomatic Cardiac Ischemia Pilot (ACIP) trial by 48-hour AECG monitoring were investigated to identify factors associated with ACI. A total of 1,820 patients with ischemia on a screening stress test and/or known or suspected coronary artery disease underwent AECG monitoring. Their mean age was 61 years, range 33 to 89; 83% were men and 81% were white. On AECG monitoring, ACI occurred in 897 patients (49%). There was a modest trend (p=0.04) between increasing age and ACI prevalence. Increased risk for ACI was observed in patients reporting angina 6 weeks before screening (odds ratio 1.38, 99% confidence interval 1.08 to 1.77, p=0.0008). There was a positive association between increases in heart rate during daily life and ACI prevalence (p <0.0001). No daily, monthly, or seasonal variation in ACI prevalence was found, although ACI was more prevalent in northern than southern sites. In this group of clinically stable patients, selected on the basis of high risk for coronary artery disease, the prevalence of ACI was higher than expected from previous reports. Several readily available clinical characteristics (i.e., advanced age, recent angina, increased heart rate change with daily activity) were associated with significantly increased probability of ACI.
AB - Cardiac ischemia during daily life activities, detected by ambulatory electrocardiographic (AECG) monitoring has been associated with increased risk for adverse outcomes. Because daily life ischemia is usually asymptomatic, prevalence and descriptive data of patients with asymptomatic cardiac ischemia (ACI) are not well defined. Accordingly, patients screened for the Asymptomatic Cardiac Ischemia Pilot (ACIP) trial by 48-hour AECG monitoring were investigated to identify factors associated with ACI. A total of 1,820 patients with ischemia on a screening stress test and/or known or suspected coronary artery disease underwent AECG monitoring. Their mean age was 61 years, range 33 to 89; 83% were men and 81% were white. On AECG monitoring, ACI occurred in 897 patients (49%). There was a modest trend (p=0.04) between increasing age and ACI prevalence. Increased risk for ACI was observed in patients reporting angina 6 weeks before screening (odds ratio 1.38, 99% confidence interval 1.08 to 1.77, p=0.0008). There was a positive association between increases in heart rate during daily life and ACI prevalence (p <0.0001). No daily, monthly, or seasonal variation in ACI prevalence was found, although ACI was more prevalent in northern than southern sites. In this group of clinically stable patients, selected on the basis of high risk for coronary artery disease, the prevalence of ACI was higher than expected from previous reports. Several readily available clinical characteristics (i.e., advanced age, recent angina, increased heart rate change with daily activity) were associated with significantly increased probability of ACI.
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U2 - 10.1016/S0002-9149(96)00190-7
DO - 10.1016/S0002-9149(96)00190-7
M3 - Article
C2 - 8677864
AN - SCOPUS:0030585720
SN - 0002-9149
VL - 77
SP - 1267
EP - 1272
JO - American Journal of Cardiology
JF - American Journal of Cardiology
IS - 15
ER -