Small and large vessel disease in persons with unrecognized compared to recognized myocardial infarction: The Tromso Study 2007-2008
Small and large vessel disease in persons with unrecognized compared to recognized myocardial infarction: The Tromso Study 2007-2008
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DOI：
10.1016/j.ijcard.2017.10.009
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发表时间：
2018-02-15
影响因子：
3.5
通讯作者：
Lindekleiv, Haakon
中科院分区：
文献类型：
--
作者：
Ohrn, Andrea Milde;Schirmer, Henrik;Lindekleiv, Haakon
背景：未被识别的心肌梗死（MI）是一种常见的疾病，其潜在原因尚不清楚。我们假设缺乏识别MI的病理生理学，特别是在潜在的小血管和大血管diseases.Methods的差异：6128名参与者进行了检查，视网膜摄影，超声的颈动脉和12导联心电图（ECG）。小血管疾病定义为视网膜照片上测量的视网膜小动脉变窄和/或视网膜小静脉变宽。大血管疾病定义为颈动脉病变。我们将未识别的MI定义为ECG证据显示的MI，但无临床识别的事件。我们分析了心肌梗死识别和标记物之间的横截面关系的小血管和大血管疾病，调整年龄和sex.Results：未识别的心肌梗死是存在于502（8.2%）和公认的MI在326（5.3%）的6128名参与者。与已识别的MI相比，未识别的MI与视网膜小动脉狭窄的小血管病变相关（OR 1.66，95%CI 1.05-2.62，最高与最低四分位数）。未识别的MI与视网膜小静脉变宽的相关性较低（OR 0.55，95%CI 0.35-0.87，最低与最高四分位数）。与确认的MI相比，未确认的MI与颈动脉斑块显示的大血管疾病的相关性较低（未确认的MI中颈动脉斑块存在的OR为0.51，95%CI为0.37-0.69）。没有显着的性别相互作用presented.Conclusions：未识别的MI与小血管疾病和大血管疾病的相关性较低，而公认的MI。这些发现表明，未识别和识别MI背后的病理生理学可能不同。(c)2017爱思唯尔B. V.保留所有权利。
Background: Unrecognized myocardial infarction (MI) is a frequent condition with unknown underlying reason. We hypothesized the lack of recognition of Ml is related to pathophysiology, specifically differences in underlying small and large vessel disease.Methods: 6128 participants were examined with retinal photography, ultrasound of the carotid artery and a 12 lead electrocardiography (ECG). Small vessel disease was defined as narrower retinal arterioles and/or wider retinal venules measured on retinal photographs. Large vessel disease was defined as carotid artery pathology. We defined unrecognized MI as ECG-evidence of MI without a clinically recognized event. We analyzed the cross-sectional relationship between MI recognition and markers of small and large vessel disease, adjusted for age and sex.Results: Unrecognized MI was present in 502 (8.2%) and recognized MI in 326 (5.3%) of the 6128 participants. Compared to recognized MI, unrecognized MI was associated with small vessel disease indicated by narrower retinal arterioles (OR 1.66,95% CI 1.05-2.62, highest vs. lowest quartile). Unrecognized MI was less associated with wider retinal venules (OR 0.55,95% CI 0.35-0.87, lowest vs. highest quartile). Compared to recognized MI, unrecognized MI was less associated with large vessel disease indicated by presence of plaque in the carotid artery (OR for presence of carotid artery plaque in unrecognized MI 0.51,95% CI 0.37-0.69). No significant sex interaction was present.Conclusions: Unrecognized MI was more associated with small vessel disease and less associated with large vessel disease compared to recognized MI. These findings suggest that the pathophysiology behind unrecognized and recognized MI may differ. (c) 2017 Elsevier B.V. All rights reserved.