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Prior epidemiologic studies based on electrocardiograms have indicated that many acute MIs are “silent” (i.e., go unnoticed). Delayed enhancement cardiac magnetic resonance (DE-CMR) imaging with gadolinium contrast can identify myocardial scars and has greater sensitivity than electrocardiography does for silent MI. Investigators in the Netherlands employed this technique to assess the prevalence and correlates of silent MI in a population with hypertension but without known coronary artery disease.
DE-CMR images were satisfactory in 480 (96%) of eligible patients (mean age, 53; 61% men). A silent MI was identified in 45 (9.4%) of all evaluated patients (13% of the men, and 4% of the women). Older age, male sex, and a history of smoking were…