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Silent Myocardial Ischaemia and
Selected Risk Factors of Coronary Artery
Disease (CAD)

Andrzej, Bissinger; Tomasz, Brot;
*Zbigniew, Baj.

Department of Cardiology, M. Pirogow's City Hospital, Lodz,
Poland *Department of Pathophysiology and Clinical Immunology,
Military Medical Academy, Lodz, Poland

There are many recognized factors having influence on the prognosis of CAD patients. Important factors are: tobacco smoking, obesity, lipid disorders, rise of inflammation markers (acute-phase proteins) and cardiac-specific troponin T level. The presence of the silent ischaemic events is a disadvantageous phenomenon in patients with CAD.
The aim of our investigation was the correlation between mentioned above factors and incidents of silent myocardial ischaemia.

We examined 42 patients with stable CAD, without anginal pains. We performed 24h Holter ECG monitoring where quantity and intensity "ST episodes" were noted. In the morning hours during monitoring blood samples were drawn and tested for: leukocytosis, fibrinogen, homocysteine, C-reactive protein, urinary acid, LDL cholesterol and troponin-T concentrations. The silent ischaemic events were recorded in 24 (57%) patients. Number and intensity of "ST episodes" showed strong positive correlation with troponin-T level (r = 0.75, p<0.001), fibrinogen concentration (r = 0.59, p<0.01) and LDL-cholesterol level (r = 0.47, p<0.05). We did not observe significant correlation with remaining laboratory parameters and with body mass index or smoking.

Conclusions: Silent myocardial ischaemia occurs at over 50% of asymptomatic CAD patients. Initial results suggest that troponin-T and fibrinogen concentrations may function as surrogate markers for the risk of silent ischaemic incidents.



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2nd Virtual Congress of Cardiology

Dr. Florencio Garófalo
Steering Committee
Dr. Raúl Bretal
Scientific Committee
Dr. Armando Pacher
Technical Committee - CETIFAC

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