Effects of anti-ischaemic drug therapy in silent myocardial ischaemia type I: the Swiss Interventional Study on Silent Ischaemia type I (SWISSI I): a randomized, controlled pilot study

Erne, Paul; Schoenenberger, Andreas W; Zuber, Michel; Burckhardt, Dieter; Kiowski, Wolfgang; Dubach, Paul; Resink, Therese; Pfisterer, Matthias (2007). Effects of anti-ischaemic drug therapy in silent myocardial ischaemia type I: the Swiss Interventional Study on Silent Ischaemia type I (SWISSI I): a randomized, controlled pilot study. European Heart Journal, 28(17), pp. 2110-7. Oxford: Oxford University Press 10.1093/eurheartj/ehm273

[img]
Preview
Text
ehm273.pdf - Published Version
Available under License Publisher holds Copyright.

Download (253kB) | Preview

AIMS: To determine the effect of anti-ischaemic drug therapy on long-term outcomes of asymptomatic patients without coronary artery disease (CAD) history but silent exercise ST-depression. METHODS AND RESULTS: In a randomized multicentre trial, 263 of 522 asymptomatic subjects without CAD but at least one CAD risk factor in whom silent ischaemia by exercise ECG was confirmed by stress imaging were asked to participate. The 54 (21%) consenting patients were randomized to anti-anginal drug therapy in addition to risk factor control (MED, n = 26) or risk factor control-only (RFC, n = 28). They were followed yearly for 11.2 +/- 2.2 years. During 483 patient-years, cardiac death, non-fatal myocardial infarction, or acute coronary syndrome requiring hospitalization or revascularization occurred in 3 (12%) of MED vs. 17 (61%) of RFC patients (P < 0.001). In addition, MED patients had consistently lower rates of exercise-induced ischaemia during follow-up, and left ventricular ejection fraction remained unchanged (-0.7%, P = 0.597) in contrast to RFC patients in whom it decreased over time (-6.0%, P = 0.006). CONCLUSION: Anti-ischaemic drug therapy and aspirin seem to reduce cardiac events in subjects with asymptomatic ischaemia type I. In such patients, exercise-induced ST-segment depression should be verified by stress imaging; if silent ischaemia is documented, anti-ischaemic drug therapy and aspirin should be considered.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Geriatric Clinic

UniBE Contributor:

Schoenenberger, Andreas

ISSN:

0195-668X

ISBN:

17644512

Publisher:

Oxford University Press

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 14:58

Last Modified:

04 Oct 2018 15:49

Publisher DOI:

10.1093/eurheartj/ehm273

PubMed ID:

17644512

Web of Science ID:

000249763800004

BORIS DOI:

10.7892/boris.24866

URI:

https://boris.unibe.ch/id/eprint/24866 (FactScience: 53388)

Actions (login required)

Edit item Edit item
Provide Feedback