Preinfarction angina and in-hospital outcome of elderly patients with acute myocardial infarction.
BACKGROUND
Preinfarction angina (PIA) may be a marker of ischemic preconditioning. A decrease in infarct size, ventricular remodeling, congestive heart failure, cardiogenic shock or death was demonstrated in the presence of preinfarction angina. These findings were more evident in adults, but not in the elderly.


OBJECTIVE
To assess the relationship between PIA and the clinical course of elderly patients with acute myocardial infarction (AMI).


METHODS
This was a case-series study with a comparison group. A total of 36 patients with ST-segment elevation AMI were included in the study and divided into two groups: group A (21 patients with PIA) and group B (15 patients without PIA).


RESULTS
Mean age of the study population was 70.5 years, and there was a predominance of males (73%). Mean body mass index was 25.3 Kg/m2. Hypertension was present in 77.8%, diabetes in 27.8% and dyslipidemia in 32.4%. Type-A chest pain was reported by 71.4% of patients, and the majority of them (72.2%) were in Killip class I. Clinical endpoints for groups A and B were as follows: postinfarction angina 9.5% versus 20%, p = 0.630; heart failure 23.8% versus 13.3%, p = 0.674; urgent revascularization 4.8% versus 6.7%, p = 1; and cardiac arrhythmia 0% versus 6.7%, p = 0.417. There was no case of reinfarction, cardiogenic shock or death within 30 days of follow up in either group.


CONCLUSIONS
In this case series, preinfarction angina was not associated with better clinical course in elderly patients with AMI.
Shian
Chiu Wen
CW
Hospital Agamenon Magalhães, Hospital das Clínicas (UFPE), Recife, PE - Brazil.
Lima
Sandro Gonçalves de
SG
Markman Filho
Brivaldo
B
D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D000789:Angina, Unstable / Q000150:complications*; D001145:Arrhythmias, Cardiac / Q000150:complications / Q000175:diagnosis; D015415:Biomarkers; D016022:Case-Control Studies; D003627:Data Interpretation, Statistical; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000175:diagnosis; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy / Q000209:etiology*; D009204:Myocardial Revascularization / Q000706:statistics & numerical data; D011446:Prospective Studies; D012307:Risk Factors; D012770:Shock, Cardiogenic / Q000209:etiology
D015415:Biomarkers