Effect of preinfarction angina pectoris on myocardial blush grade after reperfusion in first anterior wall acute myocardial infarction.
BACKGROUND
The aim of the present study was to clarify the effect of preinfarction angina pectoris (PIA) on myocardial blush grade (MBG), a simple marker of myocardial tissue-level reperfusion, in acute myocardial infarction (AMI).


RESULTS
One hundred forty-two patients with first anterior wall AMI who were admitted within 6 h after onset of symptoms were examined. PIA was defined as typical chest pain within 48 h before onset of symptoms. MBG was evaluated by coronary angiography after reperfusion. Patients with MBG 2 or 3 (n=103) had a higher frequency of PIA and a lower frequency of diabetes mellitus than those with MBG 0 or 1 (n=39) (57% vs 28%, p=0.004, and 23% vs 44%, p=0.03, respectively). The former had a lower peak creatine kinase level and a greater left ventricular ejection fraction at predischarge than the latter (3,652+/-2,440 vs 5,507+/-3,058 IU/L, p=0.0002, and 57+/-12% vs 45+/-11%, p<0.0001, respectively). Multivariate logistic regression analysis showed that PIA (p=0.004) and diabetes mellitus (p=0.03) were independently associated with MBG 2 or 3 after reperfusion.


CONCLUSIONS
PIA has beneficial effects on myocardial tissue-level reperfusion evaluated by MBG in first anterior wall AMI.
Tamura
Akira
A
Second Department of Internal Medicine, Faculty of Medicine, Oita University, Hasama, Oita, Japan. akira@med.oita-u.ac.jp
Shinozaki
Kazuhiro
K
Watanabe
Toru
T
Nakaishi
Toru
T
Nagase
Kimiaki
K
Kadota
Jun-ichi
J
D000208:Acute Disease; D000368:Aged; D000787:Angina Pectoris / Q000150:complications / Q000000981:diagnostic imaging* / Q000628:therapy; D017023:Coronary Angiography; D048909:Diabetes Complications / Q000000981:diagnostic imaging; D005069:Evaluation Studies as Topic; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000209:etiology / Q000628:therapy; D015425:Myocardial Reperfusion; D011237:Predictive Value of Tests; D016277:Ventricular Function, Left