[Effects of preceding stable or unstable angina on hospital morbidity-mortality of myocardial infarction. Results of a continuous series of 1,910 patients].
The aim of this study was to determine the effect of preceding unstable angina on the short-term prognosis of myocardial infarction based on early complications: cardiac failure, cardiac rupture, ventricular septal defect, sustained ventricular tachycardia ventricular fibrillation and hospital mortality. A continuous series of 1,910 patients admitted with 7 days of myocardial infarction was analysed retrospectively. The patients were divided into two groups according to their previous coronary history: Group A (myocardial infarction preceded by unstable angina) and Group B (myocardial infarction without preceding unstable angina). Group B was subdivided into Group B1 (myocardial infarction de novo) and Group B2 (myocardial infarction with previous stable angina). The results showed that patients with previous unstable angina (Group A) had a lower hospital mortality (7.9%) than those without (Group B) (13.3%) (p = 00017), fewer cardiac ruptures (1.1 versus 2.9%, p = 0.03) and less ventricular fibrillation (2.6 versus 4.5%, p = 0.053). Subgroups analysis showed that patients with de novo myocardial infarction (Group B1) had more sustained ventricular tachycardia than those with previous stable angina (Group B2) (5.3 versus 2.7%, p = 0.04). The authors conclude that pre-infarction unstable angina, possibly by ischaemic pre-conditioning, is an independent factor of a better prognosis in myocardial infarction.
Fichaux
O
O
Service de cardiologie A, CHU de Tours, hôpital Trousseau, 37044 Tours.
Pacouret
G
G
Djeffal-Vincentelli
D
D
Hamel
E
E
Peycher
P
P
Maillard
L
L
Charbonnier
B
B
D000368:Aged; D000789:Angina, Unstable / Q000150:complications*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008487:Medical History Taking; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000473:pathology*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D017180:Tachycardia, Ventricular / Q000209:etiology / Q000473:pathology; D014693:Ventricular Fibrillation / Q000209:etiology / Q000473:pathology
Influence de l'angor préalable stable ou instable sur la morbidité-mortalité hospitalière de l'infarctus du myocarde. Résultats d'une série continue de 1,910 patients.