Preinfarction angina prior to first myocardial infarction does not influence long-term prognosis: a retrospective study with subgroup analysis in elderly and diabetic patients.
OBJECTIVE
Although prodromal angina occurring shortly before an acute myocardial infarction (MI) has protective effects against in-hospital complications, this effect has not been well documented after initial hospitalization, especially in older or diabetic patients. We examined whether angina 1 week before a first MI provides protection in these patients.


METHODS
A total of 290 consecutive patients, 143 elderly (>64 years of age) and 147 adults (<65 years of age), 68 of whom were diabetic (23.4%) and 222 nondiabetic (76.6%), were examined to assess the effect of preceding angina on long-term prognosis (56 months) after initial hospitalization for a first MI.


RESULTS
No significant differences were found in long-term complications after initial hospitalization in these adult and elderly patients according to whether or not they had prodromal angina (44.4% with angina vs 45.4% without in adults; 45.5% vs 58% in elderly, P < 0.2). Nor were differences found according to their diabetic status (61.5% with angina vs 72.7% without in diabetics; 37.3% vs 38.3% in nondiabetics; P = 0.4).


CONCLUSIONS
The occurrence of angina 1 week before a first MI does not confer long-term protection against cardiovascular complications after initial hospitalization in adult or elderly patients, whether or not they have diabetes.
Jiménez-Navarro
Manuel F
MF
Servicio de Cardiología, Hospital Clínico Universitario Virgen de la Victoria, Campus de Teatinos s/n, Málaga, Spain. jimeneznavarro@secardiologia.es
Muñoz-García
Antonio
A
Ramirez-Marrero
Miguel A
MA
Dominguez-Franco
Antonio
A
García Alcántara
Angel
A
Gómez-Doblas
Juan José
JJ
Alonso-Briales
Juan
J
Hernández-García
José María
JM
Salva
Dolores
D
Rodriguez-Losada
N
N
de Teresa
Eduardo
E
D000368:Aged; D000787:Angina Pectoris / Q000150:complications* / Q000401:mortality / Q000628:therapy; D000789:Angina, Unstable / Q000209:etiology; D048909:Diabetes Complications / Q000401:mortality / Q000628:therapy; D006333:Heart Failure / Q000209:etiology; D006760:Hospitalization; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000401:mortality / Q000628:therapy; D010359:Patient Readmission; D016016:Proportional Hazards Models; D012008:Recurrence; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D015912:Thrombolytic Therapy / Q000009:adverse effects / Q000401:mortality; D013997:Time Factors; D016896:Treatment Outcome