Antecedent angina pectoris as a predictor of better functional and clinical outcomes in patients with an inferior wall acute myocardial infarction

Koichi Inoue, Hiroshi Ito, Masafumi Kitakaze, Tsunehiko Kuzuya, Masatsugu Hori, Katsuomi Iwakura, Nagahiro Nishikawa, Yorihiko Higashino, Kenshi Fujii, Takazo Minamino

Research output: Contribution to journalArticlepeer-review

10 Citations (Scopus)

Abstract

We examined whether angina pectoris (AP) occurring shortly before the onset of acute myocardial infarction (AMI) can render the right ventricle and the conducting tissue resistant to ischemia in 75 patients with an inferior wall AMI. Each patient had total occlusion in the proximal right coronary artery and underwent successful coronary angioplasty ≤24 hours from the onset. We divided patients into 2 groups based on presence or absence of antecedent AP ≤24 hours before the system onset: group 1 (absent) = 57 patients; group 2 (present) = 18 patients. Collateral circulation was more frequently observed in group 2 than in group 1 (group 1 vs 2, 28% vs 61%, p <0.01). Elevation in ST segment ≥1 mm in lead V(4R), hemodynamic right ventricular dysfunction, and frequency of high-degree heart block were more frequent in group 1 than in group 2 (75% vs 44%, 79% vs 39%, 53% vs 11%, p <0.05, respectively). Multivariate analysis demonstrated that antecedent AP is the only factor related to these complications. Thus, episodes of AP occurring shortly before onset may restrain development of ischemic damage of the right ventricle and conducting tissue, and are associated with better clinical and functional outcomes among patients with an inferior wall AMI.

Original languageEnglish
Pages (from-to)159-163
Number of pages5
JournalAmerican Journal of Cardiology
Volume83
Issue number2
DOIs
Publication statusPublished - Jan 15 1999
Externally publishedYes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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