Key result
Silent myocardial ischemia yields similar 7-year survival compared to symptomatic ischemia in CAD.
Why the study?
The clinical significance of ischemic ST-segment depression without chest pain (silent myocardial ischemia) during exercise testing in patients with coronary artery disease was unclear.
Does silent myocardial ischemia during exercise testing affect 7-year survival in patients with coronary artery disease compared to symptomatic ischemia?
Population
2,982 patients from the CASS registry who underwent coronary arteriography and exercise testing
Comparison
Ischemic ST-segment depression without angina vs angina without ischemic ST depression vs both vs neither during exercise testing
Design
Cohort study
Follow-up
7 years
Authors
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Silent ischemia on exercise testing should not yet change CAD management; leaves open whether symptoms add prognostic value beyond disease severity.
Cohort (n=2,982)
Does silent myocardial ischemia during exercise testing affect 7-year survival in patients with coronary artery disease compared to symptomatic ischemia?
Absolute Event Rate: 76% vs 77%
In patients with coronary artery disease, silent myocardial ischemia during exercise testing carries a similar 7-year prognosis to symptomatic ischemia, with survival primarily determined by the severity of CAD.
Weiner et al. (1987) conducted a cohort in Coronary artery disease (CAD) (n=2,982). Ischemic ST-segment depression without angina (silent myocardial ischemia) vs. Angina without ischemic ST depression was evaluated on 7-year survival rate. In patients with CAD, 7-year survival was similar for those with silent myocardial ischemia (76%) and those with angina (77%) during exercise testing, with prognosis determined by CAD severity.
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