• Eknath Naik, Deepa Dongarwar, Fabio Leonelli, Philip Foulis, Paul Leaverton, Christine Le, Deepika Kulkarni, Koushik Reddy, Amy Alman, Phong Ong, Adam Zoble, and Hamisu M Salihu.
• From the Emergency Department, West Palm Beach Veterans Affairs Hospital, Riviera Beach, Florida, the College of Public Health and the Morsani College of Medicine, University of South Florida, Tampa, the Baylor College of Medicine, Houston, Texas, and the James A. Haley Veterans Affairs Medical Center, Tampa, Florida.
• South. Med. J. 2021 Jul 1; 114 (7): 419-423.

ObjectivesIn the management of cardiovascular disease, it is important to identify patients at risk early on, to provide interventions to prevent the disease and its complications. The goal of our study was to investigate the association between glucose levels and silent myocardial infarction (SMI) among patients, who consisted of veterans within the Veterans Affairs clinical system.MethodsAmong the group of patients with an initially normal electrocardiogram, a cohort of patients with a subsequent diagnosis of SMI was selected as the case cohort, whereas 4 patients for each study subject, without evidence of coronary artery disease and normal electrocardiogram within the previous 6 months, were identified and constituted the control cohort. We conducted an adjusted logistic regression model using the stepwise function to assess the association between glucose level and SMI.ResultsOf the 540 patients included in the study, 108 (20.0%) with an SMI diagnosis made up the case cohort. We observed that as compared with those who had normal levels of glucose, those who were prediabetic were 3.99 times as likely (95% confidence interval 1.48-12.85) to have SMI, whereas the diabetic patients were 3.80 times as likely (95% confidence interval 1.39-12.38) to experience SMI.ConclusionsSMIs have been shown to be predictive of subsequent cardiovascular events, including another MI and death, and that indicates the importance of identifying a group at high risk for a SMI. As such, our findings could be extremely beneficial for targeted intervention toward prediabetics and to improve health outcomes in the entire population.

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