| Preinfarction angina prevents left ventricular remodeling in patients treated with thrombolysis for myocardial infarction. | |
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MedLine Citation:
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PMID: 11346243 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: It has been shown that preinfarction angina may have beneficial effects on infarct size and mortality. However, there are no studies that have serially assessed the impact of preinfarction angina on left ventricular (LV) function in a large series of patients. HYPOTHESIS: The study was undertaken to determine whether preinfarction angina (within 7 days before infarction) influences LV remodeling. METHODS: In all, 119 consecutive patients with acute myocardial infarction were serially evaluated by 2-dimensional echocardiography (on Days 1, 2, 3, and 7; at 3 and 6 weeks; and at 3, 6, and 12 months following infarction). Left ventricular volumes were determined using Simpson's biplane formula and normalized for body surface area. Wall motion score index and sphericity index were calculated for each study. Coronary angiography was performed before discharge. RESULTS: Preinfarction angina was detected in 39 of 119 patients. Initial echocardiographic and clinical data as well as the incidence of patent infarct-related artery and collaterals were similar for patients with and without preinfarction angina. In the subset of thrombolysed patients, patients with preinfarction angina showed decrease of LV end-diastolic and end-systolic volumes during the follow-up period (p = 0.033 and p = 0.001, respectively), and improvement of wall motion score index (p < 0.001) and ejection fraction occurred (p = 0.001), without changing of LV shape (p > 0.05); in addition, patients with preinfarction angina had smaller LV volumes and higher ejection fraction than did those without angina, from 3 weeks onward. These favorable effects were not detected in patients not treated with thrombolysis. CONCLUSIONS: These data indicate that preinfarction angina has an inhibiting effect on long-term LV remodeling in patients who underwent thrombolysis for first acute myocardial infarction. It appears that preinfarction angina has no impact on infarct size and early postinfarction LV function. |
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Authors:
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A N Nesković; K Pavlovski; D Bojić; Z Popović; P Otasević; A Vlahović; V Obradović; B Putniković; Z Vasiljević-Pokrajcić; M Bojić; A D Popović |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Clinical cardiology Volume: 24 ISSN: 0160-9289 ISO Abbreviation: Clin Cardiol Publication Date: 2001 May |
Date Detail:
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Created Date: 2001-05-10 Completed Date: 2001-09-27 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 7903272 Medline TA: Clin Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 364-70 Citation Subset: IM |
Affiliation:
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Dr. Aleksandar D. Popović Cardiovascular Research Center, Dedinje Cardiovascular Institute, Belgrade, Yugoslavia. |
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| MeSH Terms | |
Descriptor/Qualifier:
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Angina Pectoris
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physiopathology* Female Fibrinolytic Agents / therapeutic use Humans Male Middle Aged Myocardial Infarction / drug therapy, physiopathology* Streptokinase / therapeutic use Stroke Volume Thrombolytic Therapy Ventricular Function, Left* Ventricular Remodeling* |
| Chemical | |
Reg. No./Substance:
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0/Fibrinolytic Agents; EC 3.4.-/Streptokinase |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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