Unstable angina pectoris prior to ST elevation myocardial infarction in patients treated with primary percutaneous coronary intervention has no influence on prognosis
Language English Country Czech Republic Media print-electronic
Document type Comparative Study, Journal Article, Research Support, Non-U.S. Gov't
PubMed
24457834
DOI
10.5507/bp.2014.003
Knihovny.cz E-resources
- Keywords
- STEMI, natriuretic peptides, pre-infarction angina pectoris, primary PCI,
- MeSH
- Biomarkers metabolism MeSH
- Time-to-Treatment MeSH
- Stroke etiology MeSH
- Adult MeSH
- Myocardial Infarction mortality surgery MeSH
- Kaplan-Meier Estimate MeSH
- Percutaneous Coronary Intervention * MeSH
- Middle Aged MeSH
- Humans MeSH
- Follow-Up Studies MeSH
- Natriuretic Peptide, Brain metabolism MeSH
- Angina, Unstable complications mortality MeSH
- Peptide Fragments metabolism MeSH
- Prognosis MeSH
- Prospective Studies MeSH
- Recurrence MeSH
- Aged MeSH
- Heart Failure etiology MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Comparative Study MeSH
- Names of Substances
- Biomarkers MeSH
- Natriuretic Peptide, Brain MeSH
- Peptide Fragments MeSH
- pro-brain natriuretic peptide (1-76) MeSH Browser
BACKGROUND: Pre-infarction unstable angina pectoris (UAP) can be considered ischemic preconditioning. The aim of this study was to compare short and long term outcomes in patients with or without pre-infarction UAP and ST elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI). METHODS: 593 patients with STEMI (388 without and 205 with UAP) were evaluated. Levels of biomarkers (troponin I, BNP, NT-ProBNP, neopterin, endoglin and pentraxin-3) at hospital admission and 24 h after STEMI onset were assessed. Echocardiography was undertaken on the fourth day after MI and after 12 months. The median follow-up was 37 months. RESULTS: We found no significant differences in sex, age or risk factors for atherosclerosis between the UAP and non-UAP group. As the median time from the onset of chest pain to admission was significantly longer in the UAP group (228 min vs 258 min; P=0.009), we used a propensity score to obtain comparable matched groups for use in further analyses. The levels of NT-proBNP were significantly higher on admission and after 24 hours in the UAP group. Left ventricular functions according to invasive and echocardiographic parameters were entirely comparable at hospitalization and after 12 months. No differences were found in severity index of acute heart failure during hospitalization. The incidence of major acute coronary events during follow-up was comparable for the groups. CONCLUSIONS: In patients with STEMI treated with primary PCI, pre-infarction UAP has no beneficial clinical effect during hospitalization or during long-term follow-up.
Department of Biochemistry Faculty Hospital Brno
Department of Cardiology Faculty Hospital Brno
Department of Internal Cardiology Medical Faculty Masaryk University Brno Czech Republic
Institute of Biostatistics and Analyses Masaryk University Brno
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