Preinfarction angina prior to first myocardial infarction does not influence long-term prognosis: a retrospective study with subgroup analysis in elderly and diabetic patients

Clin Cardiol. 2009 Sep;32(9):E62-5. doi: 10.1002/clc.20513.

Abstract

Background and hypothesis: 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).

Conclusion: 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.

MeSH terms

  • Aged
  • Angina Pectoris / complications*
  • Angina Pectoris / mortality
  • Angina Pectoris / therapy
  • Angina, Unstable / etiology
  • Diabetes Complications* / mortality
  • Diabetes Complications* / therapy
  • Heart Failure / etiology
  • Hospitalization
  • Humans
  • Middle Aged
  • Myocardial Infarction / complications*
  • Myocardial Infarction / mortality
  • Myocardial Infarction / therapy
  • Patient Readmission
  • Proportional Hazards Models
  • Recurrence
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Thrombolytic Therapy* / adverse effects
  • Thrombolytic Therapy* / mortality
  • Time Factors
  • Treatment Outcome