Chonnam Med J.  2020 May;56(2):136-143. 10.4068/cmj.2020.56.2.136.

Impact of Previous Angina on Clinical Outcomes in ST-Elevation Myocardial Infarction Underwent Percutaneous Coronary Intervention

• Han X
• Jeong MH
• Won J
• Kim Y
• Kim MC
• Sim DS
• Hong YJ
• Kim JH
• Ahn Y

• KMID: 2500837
• DOI: http://doi.org/10.4068/cmj.2020.56.2.136

Abstract

The present study sought to assess the impact of previous angina symptoms on real world clinical outcomes in patients with ST-elevation myocardial infarction (STEMI) who had undergone successful percutaneous coronary interventions using drug-eluting stents (DES). Patients were selected from 13,650 consecutive patients enrolled in the Korea Acute Myocardial Infarction-National Institute of Health (KAMIR-NIH) registry. A total of 5167 STEMI patients were divided into a previous-angina group (n= 1129) and a control group (n=4038). Major adverse cardiac and cerebrovascular events (MACCEs) that included all-cause death, recurrent myocardial infarction (re-MI), repeat PCI, coronary artery bypass graft (CABG), cerebrovascular accident (CVA). Among the 5167 patients with STEMI, MACCEs had occurred in 168 patients in the previousangina group (14.9%) and 726 patients in the control group (18.0%) (HR, 0.76, 95% CI, 0.60-0.96, p=0.019) at the two-year (800-day) for clinical outcomes. Previous angina was associated with better clinical outcomes with respect to all-cause death (HR, 0.65, 95% CI, 0.44-0.96, p=0.029) and cardiac death (HR, 0.52, 95% CI, 0.31-0.84, p=0.008). Previous angina was a negative risk factor for adverse cardiac events. A previous history of angina predisposes a patient to a favorable outcome after acute myocardial infarction (AMI) in patients with DES implantation.

Keyword

Ischemic Preconditioning; Myocardial Infarction; Angina Pectoris; Drug- Eluting Stents