Association Between Preinfarction Angina and Angiographic Findings in Non-ST-Segment Elevation Myocardial Infarction
Naoki Misumida1, Akihiro Kobayashi1, Madeeha Saeed2
1Department of Internal Medicine, Mount Sinai Beth Israel, New York, New York.
Clinical Cardiology
|September 30, 2015
Summary
Preinfarction angina in non-ST-segment elevation myocardial infarction (NSTEMI) patients is linked to smaller infarct size and improved artery patency. Patients without this angina symptom face a higher risk of developing large myocardial infarctions (MI).
Area of Science:
- Cardiology
- Clinical Medicine
- Medical Research
Background:
- The relationship between preinfarction angina and angiographic outcomes in non-ST-segment elevation myocardial infarction (NSTEMI) is not well understood.
- Investigating this association can provide insights into NSTEMI pathophysiology and patient risk stratification.
Purpose of the Study:
- To determine if preinfarction angina is associated with favorable angiographic findings in patients with NSTEMI.
- To explore the impact of preinfarction angina on infarct size and infarct-related artery (IRA) patency.
Main Methods:
- Retrospective analysis of 481 NSTEMI patients undergoing coronary angiography.
- Preinfarction angina defined as chest pain within 7 days of admission.
- Infarct size assessed by peak cardiac troponin I (cTnI); large MI defined by cTnI >85th percentile; IRA patency by TIMI grade 2-3 flow.
Main Results:
- 42% of patients experienced preinfarction angina.
- Preinfarction angina was associated with smaller infarct size (lower peak cTnI, lower incidence of large MI) and IRA patency.
- Preinfarction angina and IRA patency were independent negative predictors of large MI on multivariate analysis.
Conclusions:
- Preinfarction angina predicts smaller infarct size and IRA patency in NSTEMI patients.
- NSTEMI patients without preinfarction angina are at increased risk of large myocardial infarction.
- Findings may aid in identifying high-risk NSTEMI patients needing closer monitoring or intervention.
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