Effect of Angina Pectoris Prior to First Q-Wave Acute Myocardial Infarction on Short Term Prognosis and Left Ventricular Function

PURPOSE
The aiın of this study was to assess the prognostic significance of angina pectoris one day before the development of first Q-wave acute myocardial infaretion (AMI). Patients with anterior or inferior ınyocardial infaretion were coınpared.
METHODS
A total number of 105 patients experiencing a first Q-wave anteri or (n=51 ) or inferior (n=54) myocardial infaretion were examined. The pattern of preinfarction angina was defined as angina developing during the last day (24 hours) preceding the infarction. A total of 43 patients in this study had angina before Q-wave AMI. During the convalescence period, selective coronary angiography and co ntrast left ventriculography were performed.
RESULTS
There were no significant differences between patients with and without preinfarction angina in either of the subgroups based on infarcı site with respect to age, gender, coronary risk factors, use of beta-adrenergic blockers, angiotensinconverting enzyme inhibitors or calcium channel blackers before and after infarction, proportion of patients arriving at the hospital within 6 hours after the onset of infarction. Among patients with anterior infarction, preinfarction angina was associated with lower peak creatine kinase activity (p<0.04), a Iower in-hospital ineidence of sustained ventricular tachycardia, fibrillation , pump failure (p=0.036) and cardiac mortality. In this subgroup it was also associated with a higher ejection fraction (p=0.05).
CONCLUSION
The presence of angina pectoris in last day before the development of first Q-wave AMI has a favorable effect on infarcı expansion and left ventricular function especially in patients with anterior myocardial infarction.