Key result
Self-reported MI prevalence exceeds ECG-MI by up to ~2-fold, varying widely across nations.
Why the study?
Self-report of physician diagnosis and ECG Q-waves are common measures of prior MI prevalence, but their relative accuracy and reliability across populations with varying MI prevalence is uncertain.
How does the prevalence of prior MI estimated by self-report compare to that estimated by ECG Q-waves across different populations?
Cross-Sectional (n=40,526)
Yes
How does the prevalence of prior MI estimated by self-report compare to that estimated by ECG Q-waves across different populations?
Self-reported MI and ECG Q-waves have limited accuracy and inconsistent relationships for estimating MI prevalence, particularly in populations with lower ischemic heart disease incidence.
Self-report overestimates ECG-defined prior MI prevalence inconsistently across populations; leaves open optimal ascertainment methods for epidemiological research.
OBJECTIVE: Self-report of physician diagnosis and ECG 'Q' waves are common survey measures of prior myocardial infarction (MI) prevalence. We sought to assess relative prevalence of self-reported prior MI and ECG Q-waves (ECG-MI) in populations and population subgroups with varying MI prevalence. DESIGN: A secondary analysis of seven population-based cross-sectional surveys of prevalent MI selected from a systematic review of ischaemic heart disease epidemiology. SETTING: Men and women aged 45-74 years in population-based Belgian surveys (1978--1998, n=29 419) and US National Health and Nutrition Examination Surveys (1976-1994, n=11 107). Comparison of the US and Belgian surveys with surveys in seven other nations (United Kingdom, Russia, Lithuania, Belarus, India, Turkey and Ghana). MAIN OUTCOME MEASURES: Prevalence of prior MI measured by self-report or resting ECG Q-waves (ECG-MI; Minnesota ECG codes 1.1 and 1.2). RESULTS: Self-reported prior MI prevalence was 1.5-2.6 times higher than ECG-MI in Belgian and US men aged 45-74 years and women 55-74 years. ECG-MI was more prevalent than self-reported MI in women <55 years old, and self-reported MI relatively low in US African-American men compared with US Caucasian men. In the overall nine-nation comparison, there was no consistent relationship between self-reported MI and ECG-MI. ECG-MI was higher relative to self-report in nations with lower prevalence of ischaemic heart disease. CONCLUSIONS: Self-reported MI and ECG-MI prevalence may only be reliable in higher ischaemic heart disease incidence groups. Self-report and ECG-MI have limited accuracy, and ECG Q-waves likely capture fewer prior MIs in the 21st century. The limitations of current survey prevalence measures of MI should be taken into account when measuring the burden of ischaemic heart disease in populations.
No takes yet. Share an insight, caveat, or question.
Moran et al. (2012) conducted a cross-sectional in Myocardial infarction (n=40,526). Self-reported diagnosis vs. ECG Q-waves was evaluated on Prevalence of prior MI. Self-reported prior MI prevalence was 1.5-2.6 times higher than ECG-MI in Belgian and US men aged 45-74 years and women 55-74 years, with no consistent relationship across all nine nations.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: