Preinfarction angina limits myocardial infarction size in nondiabetic patients treated with primary coronary angioplasty.
OBJECTIVE
To evaluate myocardial necrosis extent after myocardial infarction (MI) and reperfusion with primary coronary angioplasty in nondiabetic patients and the relationship with unstable preinfarction angina (PA).


METHODS
Prospective cohort study.


METHODS
Studies suggest PA limits infarct size. This effect is questioned in patients treated with primary coronary angioplasty.


METHODS
Seventy-eight, nondiabetic, consecutive MI patients.


METHODS
Primary coronary angioplasty and scintigraphic study to assess the myocardial infarct size.


METHODS
Scintigraphic myocardial infarct size.


RESULTS
There were 32 patients with PA (PA +) and 46 without PA (PA -) in the 24-h period prior to MI onset. There were no significant differences in the baseline characteristics between the two groups. The scintigraphy indicated myocardial infarct size significantly smaller in PA + patients: mean, 18.0% (SD, 14.7) vs 27.0% (SD, 20.1) [p = 0.033]. This occurs even though Thrombolysis in Myocardial Infarction grade 3 flow achieved in both groups was similar (84.8% vs 84.4%, p = 1.000). We found a higher percentage of ST-segment resolution (>/= 70%) in PA + patients (65.6% vs 45.7%, p = 0.082) together with a lower incidence of left ventricular systolic dysfunction (3.2% vs 18.6%, p = 0.071).


CONCLUSIONS
PA exerts a beneficial effect in nondiabetic patients with ST-segment elevation acute MI even when treated with primary PCI. The infarct size is limited, and left ventricular systolic function is preserved. The effects may be related to a better preservation of tissue reperfusion in patients with PA.
Iglesias-Garriz
Ignacio
I
Division of Cardiology, Hospital de León, 24071 León, Spain. med016340@saludalia.com
Fernández-Vazquez
Felipe
F
Perez
Armando
A
Jimenez-Bonilla
Julio
J
Garrote
Carmen
C
Uriarte
Pedro
P
Delafuente
Carmen
C
D000787:Angina Pectoris / Q000150:complications*; D017130:Angioplasty; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000473:pathology* / Q000601:surgery*; D013997:Time Factors