Chang, CCSpitzer, EChichareon, PTakahashi, KModolo, RKogame, NTomaniak, MKomiyama, HYap, SCHoole, SPGori, TZaman, AFrey, BCruz Ferreira, RBertrand, OFKoh, THSousa, AMoschovitis, Avan Geuns, RJSteg, PGHamm, CJüni, PVranckx, PValgimigli, MWindecker, SSerruys, PWSoliman, OOnuma, Y2020-02-062020-02-062019-12-15Am J Cardiol. 2019 Dec 15;124(12):1833-1840.http://hdl.handle.net/10400.17/3423Q-wave myocardial infarction (QWMI) comprises 2 entities. First, a clinically evident MI, which can occur spontaneously or be related to a coronary procedure. Second, silent MI which is incidentally detected on serial electrocardiographic (ECG) assessment. The prevalence of silent MI after percutaneous coronary intervention (PCI) in the drug-eluting stent era has not been fully investigated. The GLOBAL LEADERS is an all-comers multicenter trial which randomized 15,991 patients who underwent PCI to 2 antiplatelet treatment strategies. The primary end point was a composite of all-cause death or nonfatal new QWMI at 2-years follow-up. ECGs were collected at discharge, 3-month and 2-year visits, and analyzed by an independent ECG core laboratory following the Minnesota code. All new QWMI were further reviewed by a blinded independent cardiologist to identify a potential clinical correlate by reviewing clinical information. Of 15,968 participants, ECG information was complete in 14,829 (92.9%) at 2 years. A new QWMI was confirmed in 186 (1.16%) patients. Transient new Q-waves were observed in 28.5% (53 of 186) of them during the follow-up. The majority of new QWMI (78%, 146 of 186) were classified as silent MI due to the absence of a clinical correlate. Silent MI accounted for 22.1% (146 of 660) of all MI events. The prevalence of silent MI did not differ significantly between treatment strategies (experimental vs reference: 0.88% vs 0.98%, p = 0.5027). In conclusion, we document the prevalence of silent MI in an all-comers population undergoing PCI in this large-scale randomized trial.engHSM CARAgedAnalysis of VarianceAspirin / therapeutic useAsymptomatic Diseases / mortality*Coronary Angiography / methodsDrug Therapy, CombinationDrug-Eluting StentsElectrocardiography / methodsFemaleHumansInternationalityKaplan-Meier EstimateMyocardial Infarction / diagnostic imagingMaleMiddle AgedMyocardial Infarction / mortality*Myocardial Infarction / therapy*Percutaneous Coronary Intervention / methods*Percutaneous Coronary Intervention / mortalityPrognosisProspective StudiesRisk AssessmentStatistics, NonparametricSurvival AnalysisTicagrelor / therapeutic use*Treatment Outcomejournal article10.1016/j.amjcard.2019.08.049