Author/Authors :
sanati, hamid reza iran university of medical sciences - cardiovascular intervention research center, rajaie cardiovascular medical and research center, Tehran, Iran , ahmadi, samaneh iran university of medical sciences - cardiovascular intervention research center, rajaie cardiovascular medical and research center, Tehran, 1 Iran , farrashi, melody iran university of medical sciences - cardiovascular intervention research center, rajaie cardiovascular medical and research center, Tehran, Iran , sadeghipour, parham iran university of medical sciences - cardiovascular intervention research center, rajaie cardiovascular medical and research center, Tehran, Iran , firouzi, ata iran university of medical sciences - cardiovascular intervention research center, rajaie cardiovascular medical and research center, tehran, iran , zahedmehr, ali iran university of medical sciences - cardiovascular intervention research center, rajaie cardiovascular medical and research center, Tehran, Iran , shakerian, farshad iran university of medical sciences - cardiovascular intervention research center, rajaie cardiovascular medical and research center, Tehran, Iran , kiani, reza iran university of medical sciences - cardiovascular intervention research center, rajaie cardiovascular medical and research center, Tehran, Iran , shafe, omid iran university of medical sciences - cardiovascular intervention research center, rajaie cardiovascular medical and research center, Tehran, Iran , moosavi, jamal iran university of medical sciences - cardiovascular intervention research center, rajaie cardiovascular medical and research center, Tehran, Iran , bakhshande, hooman iran university of medical sciences - rajaie cardiovascular medical and research center, Tehran, Iran , hoghooghi, alireza iran university of medical sciences - cardiovascular intervention research center, rajaie cardiovascular medical and research center, Tehran, Iran , jalili, farhad iran university of medical sciences - rajaie cardiovascular medical and research center, Tehran, Iran
Abstract :
Background: Preinfarction angina has been recognized as a surrogate for preconditioning episodes. This study was designed to evaluate the cardiovascular effects of preinfarction anginal episodes among acute myocardial infarction (AMI) patients undergoing primary percutaneous coronary intervention (PCI). Materials and Methods: Of 520 patients who had undergone primary PCI, 393 patients were finally included in a prospective cohort study. Standard primary PCI procedure according to the latest guidelines was performed. The patients were divided into three groups based on previous symptoms as follows: asymptomatic (Group A), chronic stable angina (Group B) and unstable angina (Group C). Results: A total of 393 patients were evaluated. 185 (47.1%) patients were described as asymptomatic, 48 (12.2%) had stable angina and 160 (40.7%) were categorized as unstable angina. There was no significant difference among the study groups regarding pre‑ and post‑PCI thrombolysis in myocardial infarction flow grade (P = 0.81). Median of peak post‑PCI creatine‑kinase‑muscle/brain level of Group A (asymptomatic) was 250.5 (115.5–389), and it was significantly higher than Group C (176 [60.00–313.50]) (P = 0.03). Q wave formation was observed in 142 (88.75%), 31 (64.5%), and 96 (52.0%) patients of Group A, B, and C patients, respectively, which was significantly higher in asymptomatic patients (P = 0.002). There was no significant difference among the three groups regarding in‑hospital and 6‑month mortality (P = 0.36, 0.06, respectively). The composite endpoint of 6‑month mortality, acute coronary events, cerebrovascular accidents, and target vessel revascularization was not significantly different between the three groups (P = 0.11). Conclusion: Preinfarction angina among AMI patients undergoing primary PCI seems to have a limited beneficial effect on infarct size, and this benefit was not translated to any clinical benefit.
