Morbidity during five years after myocardial infarction and its relation to infarct size

Abstract

Summary:In 809 patients with a recent myocardial infarction, morbidity during 5-year follow-up was assessed. The overall 5-year mortality rate was 33% (39% in patients with larger infarcts and 26% in patients with smaller infarcts) as judged from maximum serum enzyme activity (p < ,001). In terms of morbidity, no significant association with estimated infarct size was observed. Patients with smaller infarcts tended to have a higher reinfarction rate and were rehospitalized more often, whereas a similar proportion of patients with large and small infarcts developed stroke. Among survivors, chest pain tended to be more common in patients having smaller infarcts, whereas symptoms of dyspnea and claudicatio intermittens were similar in both groups, as were smoking habits, work capability, and varying forms of medication. We thus conclude that during a 5-year follow-up after acute myocardial infarction, mortality, but not morbidity, was related to the original infarct size.

Exercise-induced cardiac preconditioning: how exercise protects your achy-breaky heart

“…Elderly humans who are sedentary appear to lose the preconditioning benefits of preinfarction angina, although the protection was seen in counterparts who exercised (1,116). Given the relationship between infarct size and mortality (50,88), exercise is postulated to promote survival by delaying cell death during metabolic challenge, reducing the mass of infarcted tissue.…”

Reduction of Ischemia/Reperfusion Injury With Bendavia, a Mitochondria‐Targeting Cytoprotective Peptide

“…Two major manifestations of reperfusion injury are myocyte death (infarction) and microvascular damage (no-reflow). Given that long-term prognosis has been linked to both size of infarction [1][2][3] and the extent of reflow, 4,5 strategies aimed to decrease infarct size or limit the amount of no-reflow have significant potential as adjuvant therapies.…”

Cardioprotection afforded by chronic exercise is mediated by the sarcolemmal, and not the mitochondrial, isoform of the KATP channel in the rat

“…Other than chronic moderate ethanol consumption (Kehl et al 2003), exercise training is the only stimulus demonstrated to sustain myocardial protection against infarction over such an extended period of time. This finding continues to be extremely relevant from a clinical standpoint, as myocardial infarction affects over 1 million Americans annually (National Health and Nutrition Examination Survey III, 2000), and size of infarction correlates inversely with chance of both short‐term (Miller et al 1995) and long‐term survival (Herlitz et al 1988).…”