Beneficial effect of preinfarction angina on in-hospital outcome is preserved in elderly patients undergoing coronary intervention for anterior acute myocardial infarction.
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.
Kosuge
Masami
M
Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan.
Kimura
Kazuo
K
Kojima
Sunao
S
Sakamoto
Tomohiro
T
Ishihara
Masaharu
M
Asada
Yujiro
Y
Tei
Chuwa
C
Miyazaki
Shunichi
S
Sonoda
Masahiro
M
Tsuchihashi
Kazufumi
K
Yamagishi
Masakazu
M
Ikeda
Yoshihiko
Y
Shirai
Mutsunori
M
Hiraoka
Hisatoyo
H
Inoue
Takeshi
T
Saito
Fumio
F
Ogawa
Hisao
H
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