[Prognostic effect of angina before acute myocardial infarction in elderly patients].
OBJECTIVE
The present study examined whether angina 48 h before acute myocardial infarction provided protection in early and adult patients. To investigate the effect of ischemic preconditioning in senescent heart.


METHODS
We retrospectively verified whether antecedent angina within 48 h myocardial infarction exerted a beneficial effect on in-hospital outcomes in adult(< 60 years old, n = 68) and elderly (> or = 60 years old, n = 118) patients.


RESULTS
In-hospital congestive heart failure was more frequent in adult patients without than in those with previous angina(16.7% vs 2.6%, P < 0.05), as were cardiogenic shock and death(23.3% vs 5. 3%, P < 0.05) and the combined end points(in-hospital congestive heart failure and shock or death) (40.0% vs 7.9%, P < 0.01). In contrast, the presence or absence of previous angina before acute myocardial infarction in elderly patients seemed to have no obvious influence, the incidence of in-hospital congestive heart failure(17.7% vs 20.0%, P > 0.05), shock and death(23.5% vs 20.3%, P > 0.05) and combined end points(41.2% vs 40.0%, P > 0.05). But the elderly patients with angina showed a significantly smaller infarct size compared with elderly patients without angina, the long-term cardiogenic death was more frequent in elderly patients without than in those with previous angina(18.0% vs 5.9%, P < 0.05).


CONCLUSIONS
The presence of angina before acute myocardial infarction seems to confer significant protection against in-hospital outcomes in adults; this effect seems to be present in elderly patients. This study suggests that the protection afforded by angina in adult and elderly patients may involve the occurrence of ischemic preconditioning.
Qu
X B
XB
Department of Geriatrics, Second Affiliated Hospital, Hunan Medical University, Changsha 410011.
Xiao
X
X
Liu
Q
Q
Liu
Y S
YS
D000368:Aged; D000369:Aged, 80 and over; D000787:Angina Pectoris / Q000175:diagnosis*; D005260:Female; D006801:Humans; D019157:Ischemic Preconditioning, Myocardial; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis*; D011379:Prognosis; D012189:Retrospective Studies