Abstract:
BACKGROUND:The timing of onset of angina before myocardial infarction in relation to outcome is unknown. METHODS AND RESULTS:We prospectively determined the importance of the time of onset of preinfarction angina in relation to 30-day outcomes in the TIMI-9B study from standardized forms. Of the 3002 patients entered into the study, 425 reported angina before their myocardial infarction. Patients with angina onset within 24 hours of infarction had a lower 30-day cardiac event rate (mortality, recurrent myocardial infarction, heart failure, or shock) at 4% than those with onset of angina >24 hours (17%; P=.030). A history of any angina alone was not associated with reduced event rate. Peak creatine kinase levels tended to be lower in the group with angina within 24 hours. These benefits were not due to higher rates of use of antianginal medicines or aspirin and were not a consequence of differences in baseline characteristics or disease states (hypertension, hypercholesterolemia) among subgroups. CONCLUSIONS:These temporal observations are consistent with the concept of preconditioning by preinfarction angina but do not rule out other mechanisms.
journal_name
Circulationjournal_title
Circulationauthors
Kloner RA,Shook T,Antman EM,Cannon CP,Przyklenk K,Yoo K,McCabe CH,Braunwald Edoi
10.1161/01.cir.97.11.1042subject
Has Abstractpub_date
1998-03-24 00:00:00pages
1042-5issue
11eissn
0009-7322issn
1524-4539journal_volume
97pub_type
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