TY - JOUR
T1 - Prevalence, determinants, and misclassification of myocardial infarction in the elderly
AU - De Bruyne, Martine C.
AU - Mosterd, Arend
AU - Hoes, Arno W.
AU - Kors, Jan A.
AU - Kruijssen, Dick A.C.M.
AU - Van Bemmel, Jan H.
AU - Hofman, Albert
AU - Grobbee, Diederick E.
PY - 1997/9/1
Y1 - 1997/9/1
N2 - We evaluated the prevalence, determinants, and misclassification of different types of myocardial infarction in 3,272 men and women age 55 years or older. We defined self-reported myocardial infarction with electrocardiographic evidence as 'typical myocardia/infarction.' We defined self-reported myocardial infarction without electrocardiographic evidence, but verified with additional clinical information, as 'non-Q-wave myocardial infarction.' Finally, we defined myocardial infarction detected by electrocardiogram that was not self-reported as 'silent myocardial infarction,' after verification of absence of symptoms. Overall, the prevalence of typical myocardial infarction was 4.1% [95% confidence interval (CI) = 3.5-4.9], of non-Q-wave myocardial infarction 2.8% (95% CI = 2.23.4), and of silent myocardial infarction 3.9% (95% CI = 3.2-4.5). Silent myocardial infarction was more prevalent in women, hypertensives, cigarette smokers, and those with higher post-load blood glucose. Self-reported myocardial infarction without electrocardiographic characteristics could be verified as myocardial infarction by means of additional clinical information in 56% of the cases. We conclude that myocardial infarction occurs frequently in the elderly without typical symptoms or electrocardiographic changes. As all these manifestations of myocardial infarction convey an increased risk of symptomatic heart disease or death, they require further attention. Misclassification due to limited sources of information can be considerable and should be taken into account in the design and interpretation of epidemiologic studies.
AB - We evaluated the prevalence, determinants, and misclassification of different types of myocardial infarction in 3,272 men and women age 55 years or older. We defined self-reported myocardial infarction with electrocardiographic evidence as 'typical myocardia/infarction.' We defined self-reported myocardial infarction without electrocardiographic evidence, but verified with additional clinical information, as 'non-Q-wave myocardial infarction.' Finally, we defined myocardial infarction detected by electrocardiogram that was not self-reported as 'silent myocardial infarction,' after verification of absence of symptoms. Overall, the prevalence of typical myocardial infarction was 4.1% [95% confidence interval (CI) = 3.5-4.9], of non-Q-wave myocardial infarction 2.8% (95% CI = 2.23.4), and of silent myocardial infarction 3.9% (95% CI = 3.2-4.5). Silent myocardial infarction was more prevalent in women, hypertensives, cigarette smokers, and those with higher post-load blood glucose. Self-reported myocardial infarction without electrocardiographic characteristics could be verified as myocardial infarction by means of additional clinical information in 56% of the cases. We conclude that myocardial infarction occurs frequently in the elderly without typical symptoms or electrocardiographic changes. As all these manifestations of myocardial infarction convey an increased risk of symptomatic heart disease or death, they require further attention. Misclassification due to limited sources of information can be considerable and should be taken into account in the design and interpretation of epidemiologic studies.
KW - Aged
KW - Cohort study
KW - Myocardial infarction
KW - Prevalence
UR - http://www.scopus.com/inward/record.url?scp=0030931798&partnerID=8YFLogxK
U2 - 10.1097/00001648-199709000-00004
DO - 10.1097/00001648-199709000-00004
M3 - Article
C2 - 9270949
AN - SCOPUS:0030931798
SN - 1044-3983
VL - 8
SP - 495
EP - 500
JO - Epidemiology
JF - Epidemiology
IS - 5
ER -