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Updated: Aug 15, 2026
Myocardial Infarction and Functional Outcome Assessment in Pigs
Published on: April 25, 2014
Preinfarction angina prevents left ventricular remodeling in patients treated with thrombolysis for myocardial
A N Nesković1, K Pavlovski, D Bojić
1Dr. Aleksandar D. Popović Cardiovascular Research Center, Dedinje Cardiovascular Institute, Belgrade, Yugoslavia.
Insights
Preinfarction angina may protect against long-term left ventricular (LV) remodeling in patients receiving thrombolysis for myocardial infarction. This protective effect on LV function was not observed in patients not treated with thrombolysis.
Area of Science:
- Cardiology
- Cardiovascular Research
- Clinical Medicine
Background:
- Preinfarction angina may reduce infarct size and mortality.
- Limited data exist on preinfarction angina's serial impact on left ventricular (LV) function post-myocardial infarction.
Purpose of the Study:
- To determine if preinfarction angina (within 7 days before infarction) influences LV remodeling.
- To assess the long-term effects of preinfarction angina on LV function and structure.
Main Methods:
- 119 patients with acute myocardial infarction were serially evaluated using 2D echocardiography over 12 months.
- Left ventricular volumes, wall motion score index, and sphericity index were calculated.
- Coronary angiography was performed before discharge.
Main Results:
- Preinfarction angina was present in 39 of 119 patients.
- In thrombolysed patients, preinfarction angina was associated with decreased LV volumes and improved ejection fraction and wall motion.
- These benefits were not seen in non-thrombolysed patients.
Conclusions:
- Preinfarction angina inhibits long-term LV remodeling in thrombolysed patients with first acute myocardial infarction.
- Preinfarction angina does not appear to affect infarct size or early postinfarction LV function.
Background:
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 119 patients. Initial 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-systolic volumes during the follow-up period (p = 0.033 and p = 0.001, respectively), and improvement of wall motion score index (p < 0.001) and ejection fraction occurred (p = 0.001), without changing of LV shape (p > 0.05); in addition, patients with preinfarction angina had smaller LV volumes and higher ejection fraction than did those without angina, from 3 weeks onward. These favorable effects were not detected in patients not treated with thrombolysis.
Conclusions:
These data indicate that preinfarction angina has an inhibiting effect on long-term LV remodeling in patients who underwent thrombolysis for first acute myocardial infarction. It appears that preinfarction angina has no impact on infarct size and early postinfarction LV function.
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