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The pre-existence of an acute coronary event predicts differences in biological parameters and clinical evolution

Andrei C Sposito1, Pedro A Lemos, Raul C Maranhão

  • 1Heart Institute (InCor), University of São Paulo Medicine School, São Paulo, Brazil. sposito@zerbini.org.br

International Journal of Cardiology
|October 16, 2003
PubMed

Insights

Patients with stable coronary artery disease (CAD) and a prior myocardial infarction (MI) have distinct biological markers and a higher risk of developing refractory angina compared to those with uneventful angina.

Area of Science:

  • Cardiology
  • Biochemistry

Background:

  • Stable angina patients are often treated similarly, regardless of prior acute coronary events.
  • Clinical experience suggests potential differences in disease behavior between these patient groups.

Purpose of the Study:

  • To investigate differences in clinical, angiographic, and biological parameters between stable angina patients with and without a prior myocardial infarction (MI).

Main Methods:

  • Compared cardiovascular risk factors, clinical evolution, angiographic data, white blood cell (WBC) count, lipids, and fibrinogen between 160 MI patients and 226 patients with uneventful angina.
  • Utilized multivariate logistic regression to identify independent predictors.

Main Results:

  • Myocardial infarction (MI) patients showed higher WBC count, fibrinogen, and lipoprotein(a), with lower HDL cholesterol and apoA1.
  • Fibrinogen, lipoprotein(a), and HDL cholesterol were independently associated with prior MI.
  • Prior MI patients were more likely to develop refractory angina, with fibrinogen levels independently predicting this outcome.

Conclusions:

  • Stable coronary artery disease (CAD) patients with prior myocardial infarction (MI) possess a distinct biological profile.
  • These patients exhibit a different clinical evolution, with a higher propensity towards refractory angina.
  • Biological markers like fibrinogen are linked to disease progression in this cohort.
Abstract

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