MI Risk Increased With Subclinical, Obstructive Coronary Atherosclerosis

TUESDAY, March 28, 2023 (HealthDay News) -- Subclinical, obstructive coronary atherosclerosis is associated with increased risk for myocardial infarction in asymptomatic persons aged 40 years and older, according to a study published online March 28 in the Annals of Internal Medicine.

Andreas Fuchs, M.D., Ph.D., from the Copenhagen University Hospital-Rigshospitalet in Denmark, and colleagues defined the characteristics of subclinical coronary atherosclerosis associated with development of myocardial infarction in a prospective cohort study involving 9,533 asymptomatic persons aged 40 years or older without known ischemic heart disease.

Of the participants, 54, 36, and 10 percent had no subclinical coronary atherosclerosis, nonobstructive disease, and obstructive disease, respectively. The researchers found that 193 persons died and 71 had myocardial infarction within a median follow-up of 3.5 years. In persons with obstructive and extensive disease, the risk for myocardial infarction was increased (adjusted relative risks, 9.19 and 7.65, respectively). Persons with obstructive-extensive or obstructive-nonextensive subclinical coronary atherosclerosis had the highest risk for myocardial infarction (adjusted relative risks, 12.48 and 8.28, respectively). Persons with extensive disease had increased risk for the composite end point of death or myocardial infarction, regardless of the degree of obstruction (for example, adjusted relative risks, 2.70 and 3.15 for nonobstructive-extensive and obstructive-extensive, respectively).

"In asymptomatic middle-aged persons of the background population without known ischemic heart disease, obstructive subclinical coronary atherosclerosis has the highest risk for subsequent development of myocardial infarction," the authors write.

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