The prognostic significance of angina pectoris experienced during the first month following acute myocardial infarction.
BACKGROUND
Angina pectoris accompanied by transient ST-segment changes during the in-hospital phase of acute myocardial infarction (AMI) is a well established marker of subsequent cardiac death and reinfarction.


OBJECTIVE
This study was undertaken to record the prognostic significance of angina pectoris experienced during the first month following discharge from AMI.


METHODS
In all, 803 patients included in the placebo arm of the Danish Verapamil Infarction Trial II were followed up for 18 months in 20 coronary care units in Denmark. The patients were randomized to placebo and were still on study treatment 1 month after discharge. Of these patients, 311 (39%) reported chest pain during the first month following discharge.


RESULTS
Patients with angina pectoris had a significantly increased risk of reinfarction [hazard 1.71; 95%-confidence limit (CL): 1.09, 2.69] and increased mortality risk which, however, only reached borderline statistical significance (hazard 1.52; 95%-CL: 0.96, 2.40). When patients were subdivided according to both angina pectoris and heart failure, those with one or both of these risk markers had significantly increased mortality (p 0.03) and reinfarction (p 0.02) rates compared with patients free of both angina pectoris and heart failure.


CONCLUSIONS
Patients with postinfarction angina pectoris have a significantly increased morbidity risk.
Jespersen
C M
CM
University of Copenhagen, Department of Cardiology, Hvidovre Hospital, Denmark.
D000328:Adult; D000368:Aged; D000787:Angina Pectoris / Q000150:complications* / Q000175:diagnosis / Q000401:mortality; D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D016001:Confidence Intervals; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000188:drug therapy* / Q000401:mortality; D011379:Prognosis; D016016:Proportional Hazards Models; D012008:Recurrence; D012044:Regression Analysis; D012307:Risk Factors; D015996:Survival Rate; D014700:Verapamil / Q000627:therapeutic use*
D002121:Calcium Channel Blockers; D014700:Verapamil