Pre-Infarction Angina and Outcomes in Non-ST-Segment Elevation Myocardial Infarction: Data from the RICO Survey

The presence of pre-infarction angina (PIA) has been shown to confer cardioprotection after ST-segment elevation myocardial infarction (STEMI). However, the clinical impact of PIA in non-ST-segment elevation myocardial infarction (NSTEMI) remains to be determined. From the obseRvatoire des Infarctus...

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Veröffentlicht in:PLoS ONE Jg. 7; H. 12; S. e48513
Hauptverfasser: Lorgis, Luc, Gudjoncik, Aurélie, Richard, Carole, Mock, Laurent, Buffet, Philippe, Brunel, Philippe, Janin-Manificat, Luc, Beer, Jean-Claude, Brunet, Damien, Touzery, Claude, Rochette, Luc, Cottin, Yves, Zeller, Marianne
Format: Journal Article
Sprache:Englisch
Veröffentlicht: United States Public Library of Science (PLoS) 18.12.2012
Public Library of Science
Schlagworte:
Aged
Angina
Angina Pectoris
Angina Pectoris - complications
Angina Pectoris - diagnosis
Angioplasty
Arrhythmias, Cardiac
Arrhythmias, Cardiac - metabolism
Body mass index
Cardiac arrhythmia
Cardiology
Cardiology - methods
Coronary Angiography
Coronary Angiography - methods
Creatine
Creatine kinase
Critical Care
Data Collection
Diabetes
Electrocardiography
Female
France
Group dynamics
Health aspects
Health Surveys
Heart
Heart attack
Heart attacks
Heart diseases
Heart failure
Heart rate
Humans
Hypertension
Insurance agents
Ischemia
Ischemia - pathology
Laboratories
Male
Medical imaging
Medicine
Middle Aged
Mortality
Multivariate Analysis
Myocardial Infarction
Myocardial Infarction - complications
Myocardial Infarction - therapy
Myocardium
Pain
Patients
Pharmacology
Prognosis
Prospective Studies
Q
R
Research Article
Science
Surveys
Treatment Outcome
Ventricle
France
ISSN:1932-6203, 1932-6203
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Zusammenfassung:The presence of pre-infarction angina (PIA) has been shown to confer cardioprotection after ST-segment elevation myocardial infarction (STEMI). However, the clinical impact of PIA in non-ST-segment elevation myocardial infarction (NSTEMI) remains to be determined. From the obseRvatoire des Infarctus de Côte d'Or (RICO) survey, 1541 consecutive patients admitted in intensive care unit with a first NSTEMI were included. Patients who experienced chest pain <7 days before the episode leading to admission were defined as having PIA and were compared with patients without PIA. Incidence of in-hospital ventricular arrhythmias (VAs), heart failure and 30-day mortality were collected. Among the 1541 patients included in the study, 693 (45%) patients presented PIA. PIA was associated with a lower creatine kinase peak, as a reflection of infarct size (231(109-520) vs. 322(148-844) IU/L, p<0.001) when compared with the group without PIA. Patients with PIA developed fewer VAs, by 3 fold (1.6% vs. 4.0%, p = 0.008) and heart failure (18.0% vs. 22.4%, p = 0.040) during the hospital stay. Overall, there was a decrease in early CV events by 26% in patients with PIA (19.2% vs. 25.9%, p = 0.002). By multivariate analysis, PIA remained independently associated with less VAs. From this large contemporary prospective study, our work showed that PIA is very frequent in patients admitted for a first NSTEMI, and is associated with a better prognosis, including reduced infarct size and in hospital VAs. Accordingly, protecting the myocardium by ischemic or pharmacological conditioning not only in STEMI, but in all type of MI merits further attention.
Bibliographie:ObjectType-Article-1
SourceType-Scholarly Journals-1
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Conceived and designed the experiments: LL MZ YC. Performed the experiments: AG CR LM PB LJ-M J-CB CT PB. Analyzed the data: MZ AG LL. Contributed reagents/materials/analysis tools: MZ DB. Wrote the paper: MZ AG CR LR.
Competing Interests: The authors have declared that no competing interests exist.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0048513