Key result
Unrecognized MI is linked to ~27% higher hypertension prevalence and elevated diabetes rates.
Why the study?
Unrecognized myocardial infarction remains undetected in the acute phase and carries an unfavourable prognosis, prompting evaluation of the burden of cardiovascular risk factors in these individuals.
Does unrecognized myocardial infarction associate with a higher burden of cardiovascular risk factors compared to individuals without MI?
Meta-Analysis (n=200,450)
Does unrecognized myocardial infarction associate with a higher burden of cardiovascular risk factors compared to individuals without MI?
Individuals with unrecognized myocardial infarction have a substantial burden of metabolic risk factors compared to those without MI, highlighting a need for improved recognition and management.
Answers are grounded in this paper and cite their sources.
Unrecognized MI links to higher hypertension and diabetes burden; leaves open whether targeted screening improves outcomes.
Unrecognized myocardial infarction (MI) is an MI that remains undetected in the acute phase and is associated with an unfavourable prognosis. With this systematic review and meta-analysis, we evaluated the burden of cardiovascular risk factors in individuals with unrecognized MI. We searched general population-based cohort studies diagnosing unrecognized MI by electrocardiogram or myocardial imaging up to 24 November 2023. Pooled mean differences (MDs) or risk ratios (RRs) with 95% confidence intervals (CIs) were determined, and random-effects meta-analyses were performed. Fourteen cohort studies were included involving 200 450 individuals (mean age 62.8 ± 9.9 years, 56.0% women), among which 4322 (2.2%) experienced unrecognized MI (mean age 66.3 ± 8.2 years, 47.8% women) and 4653 (2.1%) recognized MI (mean age 68.5 ± 7.3 years, 33.8% women). Compared to individuals without MI, those with unrecognized MI had higher body mass index (MD 0.27, 95% CI 0.16-0.39) and systolic blood pressure (MD 4.48, 95% CI 2.81-6.15) levels, and higher prevalence of hypertension (RR 1.27, 95% CI 1.06-1.51) and diabetes mellitus (RR 1.67, 95% CI 1.36-2.06). Furthermore, individuals with unrecognized MI had lower prevalence of hypertension (RR 0.92, 95% CI 0.88-0.97) and diabetes mellitus (RR 0.80, 95% CI 0.70-0.92). Individuals with unrecognized MI are characterized by a substantial burden of metabolic risk factors. Our findings suggest insufficient recognition and management of cardiovascular risk factors among individuals with unrecognized MI.
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Oortmerssen et al. (2024) conducted a meta-analysis in Unrecognized myocardial infarction (n=200,450). Unrecognized myocardial infarction vs. Individuals without MI was evaluated on Prevalence of hypertension (RR 1.27, 95% CI 1.06-1.51). Individuals with unrecognized MI had a higher prevalence of hypertension (RR 1.27; 95% CI 1.06-1.51) and diabetes mellitus (RR 1.67; 95% CI 1.36-2.06) compared to those without MI.
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