This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

A Clinical Perspective

Prakash C. Deedwania, MD; Enrique V. Carbajal, MD

Arch Intern Med. 1991;151(12):2373-2382.

Abstract
Silent myocardial ischemia has been shown to occur far more frequently than anginal episodes in patients with coronary artery disease. Both an increase in myocardial oxygen demand and abnormalities of coronary vasomotor tone appear to play a significant role in the genesis of silent ischemia. Recent data show that in excess of 40% of patients with stable angina have frequent episodes of silent ischemia. The presence of silent ischemia predicts an increased risk of coronary events and cardiac death. Based on these data, it has been proposed that anti-ischemic therapy should be directed toward control of total ischemic burden. Although several recent studies have demonstrated efficacy of various antianginal drugs in reducing the number and duration of silent ischemic episodes, none has demonstrated beneficial effect on the associated adverse prognosis.

(Arch Intern Med. 1991;151:2373-2382)

Author Affiliations
From the Division of Cardiology, Department of Medicine, Veterans Affairs Medical Center, Fresno, Calif, and the University of California at San Francisco.

Footnotes
Accepted for publication June 27, 1991.

Reprint requests to Division of Cardiology, Department of Medicine, Veterans Affairs Medical Center/University of California at San Francisco Program, 2615 E Clinton Ave, Fresno, CA 93703 (Dr Deedwania).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Review: Mechanisms of silent myocardial ischaemia: with particular reference to diabetes mellitus
Dweck et al.
British Journal of Diabetes & Vascular Disease 2009;9:99-102.
ABSTRACT  

Clinical aspects of silent myocardial ischaemia: with particular reference to diabetes mellitus
Dweck et al.
British Journal of Diabetes & Vascular Disease 2009;9:110-116.
ABSTRACT  

Long term outcome in patients with silent versus symptomatic ischaemia during dobutamine stress echocardiography
Biagini et al.
Heart 2005;91:737-742.
ABSTRACT | FULL TEXT  

Association of Hypoglycemia and Cardiac Ischemia: A study based on continuous monitoring
Desouza et al.
Diabetes Care 2003;26:1485-1489.
ABSTRACT | FULL TEXT  

Medical treatment of myocardial ischemia in coronary artery disease: effect of drug regime and irregular dosing in the CAPE II trial
Deanfield et al.
J Am Coll Cardiol 2002;40:917-925.
ABSTRACT | FULL TEXT  

Unrecognized Myocardial Infarction
Sheifer et al.
ANN INTERN MED 2001;135:801-811.
ABSTRACT | FULL TEXT  

Diagnostic and Prognostic Value of Holter-Detected ST-Segment Deviation in Unselected Patients With Chest Pain Referred for Coronary Angiography : A Long-term Follow-up Analysis
Nair et al.
Chest 2001;120:834-839.
ABSTRACT | FULL TEXT  

Silent ischemia predicts poor outcome in high-risk healthy men
Deedwania
J Am Coll Cardiol 2001;38:80-83.
FULL TEXT  

Effects of mental stress on coronary epicardial vasomotion and flow velocity in coronary artery disease: relationship with hemodynamic stress responses
Kop et al.
J Am Coll Cardiol 2001;37:1359-1366.
ABSTRACT | FULL TEXT  

ACC/AHA guidelines for ambulatory electrocardiography: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Revise the Guidelines for Ambulatory Electrocardiography) developed in collaboration with the North American Society for Pacing and Electrophysiology
Crawford et al.
J Am Coll Cardiol 1999;34:912-948.
FULL TEXT  

Landmarks in the Development of Coronary Artery Bypass Surgery
Favaloro
Circulation 1998;98:466-478.
FULL TEXT  

Prevalence of Silent Myocardial Ischemia and Arrhythmias in Patients With Coronary Heart Disease Undergoing Gastrointestinal Tract Endoscopic Procedures
Wilcox et al.
Arch Intern Med 1993;153:2325-2332.
ABSTRACT