Unstable angina pectoris prior to ST elevation myocardial infarction in patients treated with primary percutaneous coronary intervention has no influence on prognosis

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 coro...

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Main Authors: Krystyna Kluz, Jiri Parenica, Lenka Kubkova, Simona Littnerova, Josef Tomandl, Martin Poloczek, Ondrej Toman, Martin Tesak, Zdenka Cermakova, Jana Gottwaldova, Jan Manousek, Monika Pavkova Goldbergova, Jindrich Spinar, Jiri Jarkovsky
Format: Article
Language:English
Published: Palacký University Olomouc, Faculty of Medicine and Dentistry 2015-06-01
Series:Biomedical Papers
Subjects:
Online Access:https://biomed.papers.upol.cz/artkey/bio-201502-0014_Unstable_angina_pectoris_prior_to_ST_elevation_myocardial_infarction_in_patients_treated_with_primary_percutane.php
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author Krystyna Kluz
Jiri Parenica
Lenka Kubkova
Simona Littnerova
Josef Tomandl
Martin Poloczek
Ondrej Toman
Martin Tesak
Zdenka Cermakova
Jana Gottwaldova
Jan Manousek
Monika Pavkova Goldbergova
Jindrich Spinar
Jiri Jarkovsky
author_facet Krystyna Kluz
Jiri Parenica
Lenka Kubkova
Simona Littnerova
Josef Tomandl
Martin Poloczek
Ondrej Toman
Martin Tesak
Zdenka Cermakova
Jana Gottwaldova
Jan Manousek
Monika Pavkova Goldbergova
Jindrich Spinar
Jiri Jarkovsky
author_sort Krystyna Kluz
collection DOAJ
description 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.
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spelling doaj.art-01d2c7a1b9084a099220b6e91b9a6fb92022-12-21T19:09:21ZengPalacký University Olomouc, Faculty of Medicine and DentistryBiomedical Papers1213-81181804-75212015-06-01159225125810.5507/bp.2014.003bio-201502-0014Unstable angina pectoris prior to ST elevation myocardial infarction in patients treated with primary percutaneous coronary intervention has no influence on prognosisKrystyna Kluz0Jiri Parenica1Lenka Kubkova2Simona Littnerova3Josef Tomandl4Martin Poloczek5Ondrej Toman6Martin Tesak7Zdenka Cermakova8Jana Gottwaldova9Jan Manousek10Monika Pavkova Goldbergova11Jindrich Spinar12Jiri Jarkovsky13Department of Internal Cardiology, Medical Faculty, Masaryk University, Brno, Czech RepublicDepartment of Cardiology, Faculty Hospital BrnoDepartment of Internal Cardiology, Medical Faculty, Masaryk University, Brno, Czech RepublicInstitute of Biostatistics and Analyses, Masaryk University, BrnoDepartment of Internal Cardiology, Medical Faculty, Masaryk University, Brno, Czech RepublicDepartment of Cardiology, Faculty Hospital BrnoDepartment of Cardiology, Faculty Hospital BrnoDepartment of Cardiology, Faculty Hospital BrnoDepartment of Biochemistry, Faculty Hospital BrnoDepartment of Biochemistry, Faculty Hospital BrnoDepartment of Cardiology, Faculty Hospital BrnoDepartment of Internal Cardiology, Medical Faculty, Masaryk University, Brno, Czech RepublicDepartment of Internal Cardiology, Medical Faculty, Masaryk University, Brno, Czech RepublicInstitute of Biostatistics and Analyses, Masaryk University, BrnoBackground: 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.https://biomed.papers.upol.cz/artkey/bio-201502-0014_Unstable_angina_pectoris_prior_to_ST_elevation_myocardial_infarction_in_patients_treated_with_primary_percutane.phppre-infarction angina pectorisstemiprimary pcinatriuretic peptides
spellingShingle Krystyna Kluz
Jiri Parenica
Lenka Kubkova
Simona Littnerova
Josef Tomandl
Martin Poloczek
Ondrej Toman
Martin Tesak
Zdenka Cermakova
Jana Gottwaldova
Jan Manousek
Monika Pavkova Goldbergova
Jindrich Spinar
Jiri Jarkovsky
Unstable angina pectoris prior to ST elevation myocardial infarction in patients treated with primary percutaneous coronary intervention has no influence on prognosis
Biomedical Papers
pre-infarction angina pectoris
stemi
primary pci
natriuretic peptides
title Unstable angina pectoris prior to ST elevation myocardial infarction in patients treated with primary percutaneous coronary intervention has no influence on prognosis
title_full Unstable angina pectoris prior to ST elevation myocardial infarction in patients treated with primary percutaneous coronary intervention has no influence on prognosis
title_fullStr Unstable angina pectoris prior to ST elevation myocardial infarction in patients treated with primary percutaneous coronary intervention has no influence on prognosis
title_full_unstemmed Unstable angina pectoris prior to ST elevation myocardial infarction in patients treated with primary percutaneous coronary intervention has no influence on prognosis
title_short Unstable angina pectoris prior to ST elevation myocardial infarction in patients treated with primary percutaneous coronary intervention has no influence on prognosis
title_sort unstable angina pectoris prior to st elevation myocardial infarction in patients treated with primary percutaneous coronary intervention has no influence on prognosis
topic pre-infarction angina pectoris
stemi
primary pci
natriuretic peptides
url https://biomed.papers.upol.cz/artkey/bio-201502-0014_Unstable_angina_pectoris_prior_to_ST_elevation_myocardial_infarction_in_patients_treated_with_primary_percutane.php
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