Physical Inactivity is Related to Unheralded Myocardial Infarction More Than Uncomplicated Stable Angina

Abstract

ABSTRACT Background: Ischemic heart disease can vary substantially in its clinical presentation. Some patients have acute myocardial infarction (MI) without any previous signs of myocardial ischemia, whereas other patients may have stable angina pectoris for years without periods of acute instability; this suggests the possibility of different risk influence in these 2 groups of patients. Methods: Cardiovascular risk factors were compared in 112 consecutive patients with unheralded MIs (81 men; 59.9 ± 11.6 years) and in 168 consecutive patients with chronic stable angina (108 men; 58.2 ± 10.5 years) with at least 60% occlusion in lumen diameter in 1 of the coronary vessels. Results: Logistic-regression analysis revealed that physical inactivity (odds ratio [OR]: 4.32, 95% CI = 2.07, 8.99; P < 0.0001), the values of high sensitive-C-reactive protein levels (OR: 1.05, 95% CI = 1.00, 1.11; P = 0.043), diabetes (OR: 2.88, 95% CI = 1.42, 5.83; P = 0.003), and positive family history of premature coronary artery disease (OR: 1.96, 95% CI: 1.04, 3.71; P = 0.038) were independent predictors of unheralded MI versus chronic stable angina. Conclusion: In our subjects, sedentary life, diabetes mellitus, positive family history of premature coronary artery disease, and higher high sensitive-C-reactive protein levels were important independent predictors for unheralded MI, which suggests that these factors are involved in thrombosis, plaque rupture, or both.