title: Effect of pre-myocardial infarction angina pectoris on post-myocardial infarction arrhythmias after reperfusion therapy.
abstract: It has not been concluded whether there is a relation between pre-myocardial infarction angina pectoris (pre-MIAP) and reperfusion arrhythmia, although pre-MIAP has been reported to have a beneficial effect in preserving left ventricular function. Moreover, factors that are associated with reperfusion arrhythmias in patients with acute myocardial infarction (AMI) who have been successfully reperfused by reperfusion therapy are unknown. This study examined the predictive factors of reperfusion arrhythmias in patients with AMI who underwent successful reperfusion. The Japanese Intervention Trial in Myocardial Infarction study is a prospective, randomized trial that compares the outcome in patients with AMI who undergo intracoronary thrombolysis or primary percutaneous conventional coronary balloon angioplasty. One hundred ten consecutive patients with AMI who had been successfully reperfused in this study were categorized into 2 groups according to whether or not patients showed reperfusion arrhythmias. Multivariate logistic regression analysis was performed using 11 clinical factors to clarify the determinants of reperfusion arrhythmia. Reperfusion arrhythmias developed in 65 of 110 patients (59%). Multivariate logistic regression analysis confirmed that inferior AMI and pre-MIAP were independently associated with reperfusion arrhythmia. The odds ratio that predicted reperfusion arrhythmias was 2.37 (p = 0.0056) for inferior AMI. In contrast, the odds ratio was minimal at 0.24 for pre-MIAP (p = 0.036). In conclusion, pre-MIAP suppresses reperfusion arrhythmias, and inferior AMI is an independent factor for reperfusion arrhythmias.
authors.affiliation: The Second Department of Internal Medicine, Iwate Medical University, Morioka, Japan. tomonori-i@happy.odn.ne.jp
authors.forename: Tomonori
authors.initials: T
authors.lastname: Itoh
authors.forename: Ken'ichi
authors.initials: K
authors.lastname: Fukami
authors.forename: Tomomi
authors.initials: T
authors.lastname: Suzuki
authors.forename: Hidehiko
authors.initials: H
authors.lastname: Aoki
authors.forename: Kazuteru
authors.initials: K
authors.lastname: Ohira
authors.forename: Norio
authors.initials: N
authors.lastname: Satoh
authors.forename: Masashi
authors.initials: M
authors.lastname: Shibata
authors.forename: Masaki
authors.initials: M
authors.lastname: Ohsawa
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Suzuki
authors.forename: Motoyuki
authors.initials: M
authors.lastname: Nakamura
mesh_terms: D000787:Angina Pectoris / Q000150:complications*; D000800:Angioplasty, Balloon; D001145:Arrhythmias, Cardiac / Q000209:etiology*; D017023:Coronary Angiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000628:therapy*; D005996:Nitroglycerin / Q000627:therapeutic use; D010960:Plasminogen Activators / Q000627:therapeutic use; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D012737:Sex Factors; D015912:Thrombolytic Therapy; D013995:Time; D014665:Vasodilator Agents / Q000627:therapeutic use
chemical_list: D014665:Vasodilator Agents; D010960:Plasminogen Activators; D005996:Nitroglycerin