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MI is Silent Nearly Half the Time

The unsettling finding makes a case for a targeted screening strategy in higher-risk populations.

In this Medical News Minute video, developed exclusively for Practical Cardiology, Dr Bobby Lazzara top-lines results of the recent study published in Circulation that found silent myocardial infarction (MI) was equally as common as clinically recognized MI (CMI); that 45% of MIs are silent; and that there are race and sex differences in both the incidence and prognostic value of SMI.

Analysis was based on approximately 9500 subjects in the Atherosclerosis Risk in Communities (ARIC) study who were free of cardiovascular disease at baseline (visit 1, 1987–1989).

The authors say their findings underscore the importance of detecting SMI in clinical practice since these patients are largely asymptomatic; they have not received appropriate preventive care and are thus at greater risk for future events. The results also support an individualized CHD prevention plan that accounts for race and sex.


Zhang ZM, Rautaharju PM, Prineas RJ, et al. Race and sex differneces in the incidence and prognostic significance of silent myocardial infarction in the Atherosclerosis Risk in Communities (ARIC) study. Circulation. 2016;133:2141-8. doi: 10.1161/CIRCULATIONAHA.115.021177. Epub 2016 May 16.