Objective The aim of this study was to evaluate whether patients with silent myocardial ischemia and abdominal aortic aneurysm (AAA) have more long—term overall mortality (primary endpoint) and major cardiovascular (CV) events.Background Little is known about the impact of silent myocardial ischemia on the prognosis of AAA patients.Methods A total of 282 patients (71 women) with AAA and documented coronary artery disease (CAD) hospitalized in Anzhen Hospital from January 2002 to June 2010 were enrolled.All patients were performed 24 h ambulatory electrocardiogram monitors with 12 leads or exercise tests to detect silent ischemia.82 patients has silent isehemia.Kaplan—Meier curves were constructed to compare the long—term mortality and morbidity of AAA patients with silent ischemia and those without.A Cox proportional hazards model was performed to identify clinical factors associated with 2—year outcomes.The primary endpoint was overall mortality.The secondary prespecified endpoints were maior CV events.