Effects of Percutaneous Coronary Interventions in Silent Ischemia After Myocardial Infarction

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Abstract
Silent ischemia has been shown to predict adverse prognosis in patients after myocardial infarction (MI),1 coronary artery bypass graft surgery,2 and percutaneous coronary intervention (PCI) with or without stenting.3-6 Despite these consistent findings, there are few prospective data unequivocally documenting a benefit of anti-ischemic therapy on prognosis in patients with silent ischemia.7 There is some indirect evidence of a better outcome after repeat PCI for silent restenosis.6 In patients with a recent MI, the Asymptomatic Cardiac Ischemia Pilot study documented a short-term benefit of anti-ischemic drug therapy and PCI in patients with silent and symptomatic ischemic episodes.8-11

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