Unrecognized myocardial infarction (MI) is an MI that remains undetected in the acute phase and is associated with an unfavourable prognosis. With this systematic review and meta-analysis, we evaluated the burden of cardiovascular risk factors in individuals with unrecognized MI. We searched general population-based cohort studies diagnosing unrecognized MI by electrocardiogram or myocardial imaging up to 24 November 2023. Pooled mean differences (MDs) or risk ratios (RRs) with 95% confidence intervals (CIs) were determined, and random-effects meta-analyses were performed. Fourteen cohort studies were included involving 200 450 individuals (mean age 62.8 ± 9.9 years, 56.0% women), among which 4322 (2.2%) experienced unrecognized MI (mean age 66.3 ± 8.2 years, 47.8% women) and 4653 (2.1%) recognized MI (mean age 68.5 ± 7.3 years, 33.8% women). Compared to individuals without MI, those with unrecognized MI had higher body mass index (MD 0.27, 95% CI 0.16–0.39) and systolic blood pressure (MD 4.48, 95% CI 2.81–6.15) levels, and higher prevalence of hypertension (RR 1.27, 95% CI 1.06–1.51) and diabetes mellitus (RR 1.67, 95% CI 1.36–2.06). Furthermore, individuals with unrecognized MI had lower prevalence of hypertension (RR 0.92, 95% CI 0.88–0.97) and diabetes mellitus (RR 0.80, 95% CI 0.70–0.92). Individuals with unrecognized MI are characterized by a substantial burden of metabolic risk factors. Our findings suggest insufficient recognition and management of cardiovascular risk factors among individuals with unrecognized MI.

中文翻译：

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未识别心肌梗死女性和男性的危险因素负担：系统评价和荟萃分析


未被识别的心肌梗死 （MI） 是一种在急性期仍未被发现且与不良预后相关的 MI。通过这项系统评价和荟萃分析，我们评估了未识别的 MI 个体的心血管危险因素负担。我们检索了截至 2023 年 11 月 24 日通过心电图或心肌成像诊断未识别的心肌梗死的一般人群队列研究。确定合并平均差 （MDs） 或风险比 （RRs） 和 95% 置信区间 （CIs），并进行随机效应荟萃分析。纳入了 14 项队列研究，涉及 200 450 人 （平均年龄 62.8 ± 9.9 岁，56.0% 为女性），其中 4322 例 （2.2%） 患有未被识别的心肌梗死 （平均年龄 66.3 ± 8.2 岁，47.8% 为女性） 和 4653 例 （2.1%） 被识别为 心肌梗死 （平均年龄 68.5 ± 7.3 岁，33.8% 为女性）。与无心肌梗死的个体相比，未被识别的心肌梗死患者的体重指数（MD 0.27,95% CI 0.16-0.39）和收缩压（MD 4.48,95% CI 2.81-6.15）水平较高，高血压（RR 1.27,95% CI 1.06-1.51）和糖尿病（RR 1.67,95% CI 1.36-2.06）的患病率较高。此外，未被识别的心肌梗死个体高血压 （RR 0.92， 95% CI 0.88–0.97） 和糖尿病 （RR 0.80， 95% CI 0.70–0.92） 的患病率较低。未被识别的 MI 个体的特点是代谢危险因素负担沉重。我们的研究结果表明，在未被识别的 MI 患者中，对心血管危险因素的认识和管理不足。