[In-hospital mortality and early preinfarction angina: a meta-analysis of published studies]
Ignacio Iglesias-Garriz1, Carmen Garrote Coloma, Félix Corral Fernández
1Servicio de Cardiología, Hospital de León, León, España. med016340@saludalia.com
Insights
Preinfarction angina (PA), occurring 24 hours before myocardial infarction, significantly reduces in-hospital mortality by 39%. This finding suggests PA is a protective factor in acute myocardial infarction outcomes.
Area of Science:
- Cardiology
- Clinical Medicine
- Epidemiology
Context:
- Preinfarction angina (PA) is known to reduce myocardial necrosis and improve ventricular function post-myocardial infarction.
- The impact of PA on in-hospital mortality remains debated.
- This study addresses the association between PA and mortality in acute myocardial infarction patients.
Purpose:
- To determine if preinfarction angina (PA) is associated with in-hospital mortality in patients with acute myocardial infarction.
- To synthesize existing evidence through a meta-analysis.
Summary:
- A fixed-effects model meta-analysis of six studies (3497 patients) was conducted.
- PA was defined as angina occurring within 24 hours before myocardial infarction onset.
- The analysis revealed a significant reduction in in-hospital death probability (OR=0.61, P<.0001) with no significant heterogeneity.
Impact:
- Preinfarction angina is associated with a 39% reduction in in-hospital mortality.
- This suggests PA may confer a protective effect against mortality in the acute phase of myocardial infarction.
- Findings contribute to understanding the prognostic implications of preinfarction angina.
Introduction And Objectives:
The occurrence of preinfarction angina (PA) reduces the extent of myocardial necrosis, increases the volume of viable myocardium, and improves left ventricular function. However, there is no agreement about the effect of PA on mortality. The objective of this study was to determine whether PA is associated with in-hospital mortality.
Method:
A meta-analysis (fixed effects model) of all published reports evaluating in-hospital mortality in patients with acute myocardial infarction according to the presence or absence of PA was performed. PA was defined as the occurrence of angina in the 24 hours before onset of the infarction. We searched the Medline and Embase databases in June 2004 using <
Results:
Only one study reported that PA had a statistically significant beneficial effect on in-hospital mortality. However, combining the data showed that the presence of PA was associated with a significant decrease in the probability of in-hospital death (odds ratio=0.61; 95% CI: 0.48-0.78; P<.0001. We did not detect any significant heterogeneity between the studies (chi2=5.92; P=.31).
Conclusions:
The occurrence of preinfarction angina in the 24 hours before the onset of myocardial infarction was associated with a significant reduction in in-hospital mortality of 39%.
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