Document Detail


Preinfarction angina does not alter infarct size and in hospital outcome after acute myocardial infarction with ST elevation.
MedLine Citation:
PMID:  15093979     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Preinfarction angina has been reported to limit infarct size, in a manner analogous to experimental preconditioning. However, other studies have reported inconsistent results. We aimed to investigate prospectively the role of preinfarction angina on infarct size and in hospital outcome. METHODS: Ninety-nine patients were divided into three groups according to the timing of angina: the group "< 48 h" reported angina within the last 48 h, the group "> 48 h" earlier than 48 h and the group "acute" no angina before infarction. Myocardial injury was estimated by creatine kinase, creatine kinase-MB, troponin I and C-reactive protein. In hospital events included death, recurrent ischemia, congestive heart failure and atrioventricular block. RESULTS: Clinical characteristics, thrombolysis administration and the magnitude of enzymes released were not statistically different among the three groups: peak creatine kinase was 2139+/-1714 U/l for the >48 h group, vs. 2344+/-1634 U/l for the acute group, vs. 2209+/-1384 U/l for the <48 h group (p=0.88). Peak creatine kinase-MB was 124+/-104 U/l for the >48 h group, vs. 168+/-182 U/l for the acute group, vs. 154+/-108 U/l for the <48 h group (p=0.62). Peak troponin I, peak C-reactive protein and in hospital outcome also did not differ statistically in the three groups; p=0.5, p=0.45. CONCLUSIONS: Infarct size estimated by cardiac enzymes and by the marker of C-reactive protein, as well as in hospital clinical prognosis are not different in patients with and without preinfarction angina. It seems, therefore, that preinfarction angina confers ischemic conditions inadequate to mimic preconditioning.
Authors:
Stavroula N Psychari; Efstathios K Iliodromitis; Eftihia Hamodraka; Georgios Liakos; Angeliki Velissaridou; Thomas S Apostolou; Dimitrios Th Kremastinos
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  International journal of cardiology     Volume:  94     ISSN:  0167-5273     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2004 Apr 
Date Detail:
Created Date:  2004-04-19     Completed Date:  2004-08-05     Revised Date:  2006-07-12    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  187-91     Citation Subset:  IM    
Affiliation:
2nd Department of Cardiology, Nikea General Hospital, Athens, Greece. elbee@ath.forthnet.gr
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MeSH Terms
Descriptor/Qualifier:
Angina, Unstable / physiopathology*
Biological Markers / blood
C-Reactive Protein / analysis
Creatine Kinase / blood
Creatine Kinase, MB Form
Female
Hospital Mortality
Humans
Ischemic Preconditioning, Myocardial
Isoenzymes / blood
Male
Middle Aged
Myocardial Infarction / mortality,  physiopathology*
Outcome Assessment (Health Care)
Prospective Studies
Troponin I / blood
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Isoenzymes; 0/Troponin I; 9007-41-4/C-Reactive Protein; EC 2.7.3.2/Creatine Kinase; EC 2.7.3.2/Creatine Kinase, MB Form

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