title: Beneficial effect of preinfarction angina on in-hospital outcome is preserved in elderly patients undergoing coronary intervention for anterior acute myocardial infarction.
abstract: BACKGROUND
  Preinfarction angina improves survival after acute myocardial infarction (AMI) in nonelderly but not elderly patients in the thrombolytic era. However, it remains unclear whether preinfarction angina has a beneficial effect on clinical outcome in elderly patients undergoing percutaneous coronary intervention (PCI).
  
  
  RESULTS
  The study group comprised 484 anterior AMI patients who were admitted within 24 h of onset and underwent emergency PCI. Patients were divided into 2 groups: those aged < 70 years (nonelderly patients, n = 290) and those aged > or = 70 years (elderly patients, n = 194). Angina within 24 h before AMI was present in 42% of nonelderly patients and in 37% of elderly patients. In nonelderly patients, preinfarction angina was associated with a lower in-hospital mortality rate (1% vs 7%, p = 0.02). Similarly, in elderly patients, preinfarction angina was associated with a lower in-hospital mortality rate (6% vs 16%, p = 0.03). Multivariate analysis showed that the absence of preinfarction angina was an independent predictor of in-hospital mortality in both nonelderly (odds ratio 4.20; 95% confidence interval (CI) 1.20-10.6; p = 0.04) and elderly patients (odds ratio 3.04; 95%CI 1.06-18.1; p = 0.04).
  
  
  CONCLUSIONS
  Angina within the 24 h before AMI is associated with better in-hospital outcomes in elderly and nonelderly patients.
authors.affiliation: Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan.
authors.forename: Masami
authors.initials: M
authors.lastname: Kosuge
authors.forename: Kazuo
authors.initials: K
authors.lastname: Kimura
authors.forename: Sunao
authors.initials: S
authors.lastname: Kojima
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Sakamoto
authors.forename: Masaharu
authors.initials: M
authors.lastname: Ishihara
authors.forename: Yujiro
authors.initials: Y
authors.lastname: Asada
authors.forename: Chuwa
authors.initials: C
authors.lastname: Tei
authors.forename: Shunichi
authors.initials: S
authors.lastname: Miyazaki
authors.forename: Masahiro
authors.initials: M
authors.lastname: Sonoda
authors.forename: Kazufumi
authors.initials: K
authors.lastname: Tsuchihashi
authors.forename: Masakazu
authors.initials: M
authors.lastname: Yamagishi
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Ikeda
authors.forename: Mutsunori
authors.initials: M
authors.lastname: Shirai
authors.forename: Hisatoyo
authors.initials: H
authors.lastname: Hiraoka
authors.forename: Takeshi
authors.initials: T
authors.lastname: Inoue
authors.forename: Fumio
authors.initials: F
authors.lastname: Saito
authors.forename: Hisao
authors.initials: H
authors.lastname: Ogawa
mesh_terms: D000368:Aged; D000787:Angina Pectoris / Q000150:complications / Q000401:mortality; D015906:Angioplasty, Balloon, Coronary; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000401:mortality / Q000628:therapy*; D016896:Treatment Outcome