Regular paperOccurrence of unrecognized myocardial infarction in subjects aged 45 to 65 years (the ARIC study)☆
Section snippets
Subjects:
The Atherosclerosis Risk in Communities (ARIC) study is a population-based prospective cohort study of the natural history of cardiovascular disease in 4 United States communities: Forsyth County, North Carolina; Jackson, Mississippi (African-Americans only); suburban Minneapolis, Minnesota; and Washington County, Maryland. Complete details have been previously published.11 Between 1987 and 1989, men and women, ages 45 to 64 years, were recruited from each community using probability sampling
Results
A total of 508 incident MIs were identified between 1987 and 1998. The overall percentage of incident MIs categorized as unrecognized was 20% when using hospital record abstraction information to define clinically recognized MI, and 24% when clinically recognized MI was defined solely in the presence of an ICD-9 410 discharge code (Table 1). African-Americans had a slightly higher proportion of unrecognized MIs than whites.
Table 2lists the descriptive statistics of baseline cardiovascular risk
Discussion
One of the earliest longitudinal reports on the occurrence of unrecognized MI emerged from the Framingham Study, in which 21% of MIs occurring during a 7-year period were unrecognized.18 The most recent report in a series of updates from the Framingham Study was based on 34 years of follow-up between 1948 and 1982 and showed that 34% of MIs in women and 26% in men were clinically unrecognized.2 The Western Collaborative Group Study,3 the Israeli Heart Attack Study,4 the Honolulu Heart Program,5
Acknowledgements
The investigators thank the staff and participants of the ARIC study for their important contributions.
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This study was supported by contracts N01-HC-55015, N01-HC-55016, N01-HC-55018, N01-HC-55019, N01-HC-55020, N01-HC-55021, and N01-HC-55022 from the National Heart, Lung, and Blood Institute, Bethesda, Maryland.