| Preinfarction Angina Reduces Infarct Size in ST-Elevation Myocardial Infarction Treated With Percutaneous Coronary Intervention. | |
| | |
MedLine Citation:
|
PMID: 23339840 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
|
BACKGROUND: PREINFARCTION ANGINA MAY ACT AS A CLINICAL SURROGATE OF ISCHEMIC PRECONDITIONING THAT MAY REDUCE INFARCT SIZE AND IMPROVE MORTALITY IN THE SETTING OF THROMBOLYTIC THERAPY FOR ST-ELEVATION MYOCARDIAL INFARCTION. HOWEVER, THE BENEFITS OF PREINFARCTION ANGINA IN THE SETTING OF PRIMARY PERCUTANEOUS CORONARY INTERVENTION WITH STENTING IS INCONCLUSIVE BECAUSE OF THE GREATER ACHIEVEMENT OF INFARCT ARTERY PATENCY AND SPEED OF REPERFUSION.METHODS AND RESULTS: TO IDENTIFY A HOMOGENEOUS POPULATION, WE PERFORMED A RETROSPECTIVE ANALYSIS OF 1031 PATIENTS ADMITTED WITH A FIRST ST-ELEVATION MYOCARDIAL INFARCTION WITH ISCHEMIC TIMES BETWEEN 1 AND 6 HOURS WHO RECEIVED PRIMARY PERCUTANEOUS CORONARY INTERVENTION. WE IDENTIFIED 245 PATIENTS WHO HAD OCCLUDED ARTERIES ON PRESENTATION, OF WHICH 79 PATIENTS HAD DOCUMENTED PREINFARCTION ANGINA DEFINED AS CHEST PAIN WITHIN 24 HOURS OF INFARCTION. INFARCT SIZE WAS MEASURED AS THE PEAK CREATINE KINASE LEVEL, A METRIC SUPPORTED IN A SUBGROUP BY LATE ENHANCEMENT ON CARDIAC MAGNETIC RESONANCE IMAGING. PATIENTS WITH PREINFARCTION ANGINA (N=79) HAD A 50% REDUCTION IN INFARCT SIZE COMPARED WITH THOSE PATIENTS WITHOUT PREINFARCTION ANGINA (N=166) BY BOTH PEAK CREATINE KINASE (109475 IU/L VERSUS 2270102 IU/L; P0.0001) AND CREATINE KINASE AREA UNDER CURVE (18 42018 941 VERSUS 36 81021 741 IU/H PER LITER; P0.0001) DESPITE HAVING IDENTICAL ISCHEMIC TIMES (1858 MINUTES VERSUS 1815 MINUTES; P=0.67) AND ANGIOGRAPHIC AREA AT RISK (24.11.2% VERSUS 25.30.9%; P=0.43). THERE WAS AN ABSOLUTE 4% IMPROVEMENT IN LEFT VENTRICULAR EJECTION FRACTION BEFORE DISCHARGE IN THOSE PATIENTS WITH PREINFARCTION ANGINA (P0.02).CONCLUSIONS: The occurrence of preinfarction angina is associated with significant myocardial protection in the setting of primary percutaneous coronary intervention with stenting during ST-elevation myocardial infarction. Because preinfarction angina is relatively common, it is important that these patients be identified in clinical trials investigating therapies designed to reduce reperfusion injury and infarct size. |
| | |
Authors:
|
Ronald Reiter; Timothy D Henry; Jay H Traverse |
Publication Detail:
|
Type: JOURNAL ARTICLE Date: 2013-1-22 |
Journal Detail:
|
Title: Circulation. Cardiovascular interventions Volume: - ISSN: 1941-7632 ISO Abbreviation: Circ Cardiovasc Interv Publication Date: 2013 Jan |
Date Detail:
|
Created Date: 2013-1-23 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 101499602 Medline TA: Circ Cardiovasc Interv Country: - |
Other Details:
|
Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
|
Minneapolis Heart Institute Foundation at Abbott Northwestern Hospital, Minneapolis, MN; and Cardiovascular Division, The University of Minnesota Medical School, Minneapolis, MN. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Transcatheter Closure of Post-myocardial Infarction Ventricular Septal Rupture.
Next Document: Efficacy and Safety of Postdilatation to Reduce Paravalvular Regurgitation During Balloon-Expandable...