Preinfarction angina prevents left ventricular remodeling in patients treated with thrombolysis for myocardial infarction

Abstract

summaryBackground: It has been shown that preinfarction angina may have beneficial effects on infarct size and mortality. However, there are no studies that have serially assessed the impact of preinfarction angina on left ventricular (LV) function in a large series of patients.Hypothesis: The study was undertaken to determine whether preinfarction angina (within 7 days before infarction) influences LV remodeling.Methods: In all, 119 consecutive patients with acute myocardial infarction were serially evaluated by 2-dimensional echocardiography (on Days 1,2,3, and 7; at 3 and 6 weeks; and at 3,6. and 12 months following infarction). Left ventricular volumes were determined using Simpson's biplane formula and normalized for body surface area. Wall motion score index and sphericity index were calculated for each study. Coronary angiography was performed before discharge.Results: Preinfarction angina was detected in 39 of I 19 patients. lnitial echocardiographic and clinical data as well as the incidence of patent infarct-related artery and collaterals were similar for patients with and without preinfarction angina. In the subset of thrombolysed patients, patients with preinfarction angina showed decrease of LV end-diastolic and end-sys-

Preinfarction Angina Prior to First Myocardial Infarction Does not Influence Long‐Term Prognosis: A Retrospective Study with Subgroup Analysis in Elderly and Diabetic Patients

“…Several mechanisms, including ischemic preconditioning, have been proposed to explain these benefits. 6,7 However, little information is available about long-term prognosis, especially in these older and diabetic patients.…”