Prognostic significance of silent myocardial ischemia in patients with stable angina pectoris

Coronary angiography and 24 - 48 Holter ECG monitoring were performed in 115 patients with stable angina pectoris. All patients had coronary artery stenoses over 50% while 59 patients (51,3%) had episodes of silent myocardial ischemia (St-segment depressions 0,1 sm or more without angina). Analysis of results of follow-up fdr 12 - 18 months allowed to distinguish 4 variants of clinical course of the disease: 1) with cardiac events (16 patients); 2) progression (23 patients); 3) stabilization (52 patients); 4) clinical remission (24 patients). Cardiac events occurred in 75% of those patients with silent ischemia who had total ischemic burden exceeding 60 min or more and/or ST-segment depressions 3 mm and more at heart rates below 100/min. Clinical remission of angina in patients with silent ischemia occurred rarely.