Effect of previous angina pectoris upon prognosis in patients with right ventricular myocardial infarction on the background of the posterior Q-wave myocardial infarction
Article Sidebar
Main Article Content
Abstract
The aim – to evaluate impact of the previous angina pectoris (AP) on risk of complications during acute period and long-term prognosis of patients with right ventricular (RV) myocardial infarction (MI) on the background of the posterior Q-wave MI.
Material and methods. 155 patients with RV MI aged 64.11±0.78 years were evaluated. The 1st group – 97 (62.6 %) patients had chronic AP before MI, and the 2nd group – 58 (37.4 %) patients – without previous AP. Average follow-up was 30±4.5 months. Endpoints were: unstable angina (UA), recurrent MI (Re-MI), stroke, cardiovascular (CV) death and HF-hospitalizations.
Results. Patients with AP differed had older age (Р=0.005), greater frequency of diabetes mellitus (Р=0.017) and hypertension (Р=0.0013). In the acute period of the RV MI in the 1st group there was higher incidence of ventricular extrasystoles (Р=0.047), high-degree and complete AV-blockade (Р=0.023), acute HF (Killip II–III) (Р=0.017; Р=0.011), and postinfarction angina (Р=0.002). Study endpoints occurred in 65 (41.9 %) patients: UA – 50 (32.2 %), Re-MI –
15 (9.6 %), stroke – 9 (5.8 %), CV-death – 16 (10.3 %), HF-hospitalization – 22 (14.2 %). The frequency of HF-hospitalization (Р=0.013), UA (Р=0.0001), Re-MI (Р=0.025 and CV-death (Р=0.0065) were significantly higher in the 1st group. After 30-month follow-up the CV-events occurred in 51 (52.6 %) patients with previous AP when compared with 14 (24.1 %) patients in the 2nd group (Cox F-Test: Р=0.00001).
Conclusions. The chronic AP previous RV MI is associated with significant increase of the risk CV-complications, in particular, CV-death, Re-MI, UA and HF-hospitalizations during 30-months follow-up.
Article Details
Keywords:
References
Воронков Л.Г., Амосова К.М., Багрій А.Е. та ін. Рекомендації з діагностики та лікування хронічної серцевої недостатності (2012) // Серцева недостатність.– 2012.– № 3.– С. 60–96.
Abtahi F., Farmanesh M., Moaref A. et al. Right ventricular involvement in either anterior or inferior myocardial infarction // Intern. Cardiovasc. Research J.– 2016.– Vol. 10 (2).– P. 67–71.
Cohn J.N., Guiha N.H., Broder M.I. et al. Right ventricular infarction. Clinical and hemodynamic features // Am. J. Cardiol.– 1974.– Vol. 33.– P. 209–214.
Cortina A., Ambrose J.A., Prieto-Granada J. et al. Left ventricular function after myocardial infarction: Clinical and angiographic correlations // J. Am. Coll. Cardiol.– 1985.– Vol. 5.– P. 619–624.
Filippatos G., McMurray J., Aboyans V. et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) // Eur. Heart J.– 2016.– Vol. 37.– P. 2129–2200.
Graffari S., Samadikhan J. Predictive value of TIMI Risk Score analysis for in-hospital and long-term survival of patients with right ventricular infarction // Heart J.– 2006.– Vol. 7.– P. 26–30.
Haji S.A., Movahed A. Right ventricular infarction – diagnosis and treatment // Clin. Cardiol.– 2000.– Vol. 26 (7).– 2023–2033.
Hamon M., Agostini D., Page O. et al. Prognostic impact of right ventricular involvement in patients with acute myocardial infarction: meta-analysis // Crit Care Med.– 2008.– Vol. 36.– P. 2023–2033.
Herlitz J., Karlson B.W., Richter A. et al. Occurrence of angina pectoris prior to acute myocardial infarction and its relation to prognosis // Eur. Heart J.– 1993.– Vol. 14 (4).– P. 484–491.
Horan L.G., Flowers N.C. Right ventricular infarction: Specific requirements of management // Am. Fam. Physician.– 1999.– Vol. 60.– P. 1727–1734.
Iglesias-Garriz I., Garrote C.C., Corral F.F. et al. Mortalidad intrahospitalaria y angina preinfarto temprana: metaanalisis de los estudios publicados // Rev. Esp. Cardiol.– 2005.– Vol. 58.– P. 484–490.
Ishihara M., Inoue I., Kawagoe T. et al. Ischaemic preconditioning effect of prodromal angina pectoris is lost in patients with prior myocardial infarction // Heart.– 2006.– Vol. 92 (7).– P. 973–974.
Jensen C.J., Jochims M., Hunold P. et al. Right ventricular involvement in acute left ventricular myocardial infarction: prognostic implications of MRT findings // AJR.– 2010.– Vol. 194.– P. 592–598.
Jimenez-Navarro M.F., Gomez-Doblas J., Ramírez-Marrero M.A. et al. Effect of Angina in the Week Before Myocardial Infarction on Long-Term Cardiovascular Morbidity and Mortality After Hospital Discharge // Rev. Esp. Cardiol.– 2008.– Vol. 61 (7).– P. 775–778.
Kluza K., Parenicac I., Kubkovaa L. et al. Unstable angina pectoris prior to ST elevation myocardial infarction in patients treated with primary percutaneous coronary intervention has no influence on prognosis // Biomed. Pap. Med. Fac. Univ. Palacky Olomouc Czech Repub.– 2015.– Vol. 159 (2).– P. 251–258.
Mohammadzadeh H.S., Vatan K., Mikaili P. et al. The effect of prodromal angina pectoris on short-term prognosis of acute ST elevation myocardial infarction // Eur. J. Experimental Biology.– 2012.– Vol. 2 (1).– P. 217–221.
Montalescot G., Sechtem U., Achenbach S. et al. Task Force Members. 2013 ESC guidelines on the management of stable coronary artery disease: The Task Force on the management of stable coronary artery disease of the European Society of Cardiology // Eur. Heart J.– 2013.– 34.– P. 2949–3004.
Ondrus T., Kanovsky J., Novotny T. et al. Right ventricular myocardial infarction: From pathophysiology to prognosis // Exp. Clin. Cardiol.– 2013.– Vol. 18 (1).– P. 27–30.
Pereira A., Franken R., Schwarzwälder S. et al. Impact on hospital mortality and morbidity of right ventricular involvement among patients with acute left ventricular infarction // Sao Paulo Med. J.– 2006.– Vol. 124 (4).– P. 186–191.
Steg G., James S., Atar D. et al. ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. The Task Force on the management of ST-segment elevation acute myocardial infarction of the European Society of Cardiology (ESC) // Eur. Heart J.– 2012.– Vol. 33.– P. 2569–2619.