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[Influence of pre-infarction angina on mid-term mortality after acute myocardial infarction]
I Iglesias Garriz1, M Sastre Ibarretxe, S Delgado Fernández
1Servicio de Cardiología. Hospital de León. med016340@nacom.es
Insights
Pre-infarction angina did not significantly impact six-month mortality after acute myocardial infarction. However, patients without this angina showed a higher risk of death throughout the follow-up period.
Area of Science:
- Cardiology
- Clinical Medicine
- Medical Research
Context:
- Acute myocardial infarction (MI) prognosis is influenced by pre-infarction angina (PIA).
- Understanding PIA's role in post-MI outcomes is crucial for patient management.
- Previous studies suggest PIA may improve outcomes after MI.
Purpose:
- To investigate the association between pre-infarction angina and six-month total mortality following acute myocardial infarction.
- To analyze mortality rates in patients with and without pre-infarction angina post-MI.
Summary:
- A prospective study of 175 acute myocardial infarction patients found no significant difference in six-month mortality between those with (9.7%) and without (15.5%) pre-infarction angina.
- Hazard-risk curves indicated a higher risk of death during follow-up for patients without pre-infarction angina.
- Multivariate analysis did not show a significant reduction in death risk with pre-infarction angina (OR=0.43, p=0.303).
Impact:
- This study indicates pre-infarction angina may not significantly alter short-term mortality post-MI.
- A significant interaction was identified between sulfonylurea treatment and pre-infarction angina, suggesting a potential modulating effect on outcomes.
- Further research is warranted to explore the complex interplay between pre-infarction angina, medications, and myocardial infarction prognosis.
Introduction And Objectives:
Pre-infarction angina may reduce the extent of myocardial cell necrosis and improves the prognosis after myocardial infarction. The aim of this study was to analyze the total mortality six-month after acute myocardial infarction according to the presence or absence of pre-infarction angina.
Methods:
One hundred seventy-five consecutive patients with acute myocardial infarction were prospectively included, 72 (41.4%) with pre-infarction angina. They were followed for 6 months. There were 16 deaths (15.5%) in the group of patients without pre-infarction angina and 7 (9.7%) in the group with pre-infarction angina (log-rank = 1.03; p = 0.311). The hazard-risk function curves showed a higher risk of death during the entire follow-up in the group without pre-infarction angina. In the multivariate logistic regression model, the presence of pre-infarction angina does not significantly reduce the risk of death (OR = 0.43; CI 95% = 0.09-2. 22; p = 0.303). We detected a significant interaction between treatment with sulfonylureas before the infarction and the presence of pre-infarction angina (p = 0.017).
Conclusions:
In this study no significant differences were observed in total mortality six months after acute myocardial infarction according to the presence of pre-infarction angina. However, the risk of death seemed to be higher in the group of patients without pre-infarction angina during the entire follow-up. A significant interaction was found between the treatment with sulfonylurea drugs before infarction and the presence of pre-infarction angina.