The influence of angina the week before a first myocardial infarction on short and medium-term prognosis

Introduction and objectives. The implications of early angina on the progno sis of myocardial infarction are controversial. The aim of this study was t o assess the effect of angina one week before the first myocardial infarcti on on short and medium-term prognosis. Patients and method. A total of 290 consecutive patients (107 with previous angina and 183 without it) with the first myocardial infarction were studi ed to determine the effect of preceding angina on short and medium-term pro gnosis. Further criteria for inclusion were no previous history of angina > 1 week before the first myocardial infarction, and no evidence of prior str uctural cardiopathy. The end points studied were death and congestive heart failure in the acute phase of myocardial infarction and during the follow- up. Results. Patients with a history of prodromal angina were less likely to ex perience in-hospital death, heart failure or combined end-point (3.7 vs 11. 5%; 4.6 vs 15.8%; 7.5 vs; 21.3%) (p=0.002). There was also a difference bet ween groups in the follow-up (4.1 vs 13.2%; p=0.03). Multivariate analysis confirmed that the presence of preinfarction angina was an independent pred ictor of death and heart failure in the acute phase of myocardial infarctio n as well as in the follow-up. Conclusions. The occurrence of angina one week before the first myocardial infarction protects against death and heart failure in the acute phase of m yocardial infarction as well as in the medium follow-up.