Clinical analysis in acute myocardial infarction patients with previous angina pectoris

Objective:To evaluate the clinical outcomes in acute myocardial infarction (AMI) patients with previous angina pectoris(AP).Methods:Three hundred and eighty five cases with AMI were consecutively underwent coronary angiography and divided into AP group in 202 patients and Non AP group in 183 patients. The clinical and angiographic characteristics were analyzed and the major adverse cardiac events(including presence of recurrent angina, occurrence of non fatal myocardial infarction, nonfatal congestive heart failure, revascularization of target vessels and cardiac related death) were followed up in some cases at the mean duration of ( 28.7 ± 8.2 ) months after the acute epsiode.Results:Compared with Non AP group, the peak value of creatine kinase(CK) and CK MB were lower[(1965±1422) vs (3126±2108);(81±46) vs (118±56)IU/L,all P 0.01 ],but the incidence of triplevessel disease and left main coronary artery disease were higher( 33.2 % vs 16.9 %; 8.9 % vs 3.3 %,all P 0.05 ).The follow up result showed there were more incidence of recurrent angina pectoris, higher cardiac mortality and increased combined events in AP group( 36.2 %, 10.2 %, 48.0 % respectively ) than in Non Ap group( 23.6 %,P 0.01 ; 3.6 %,P 0.05 ; 30.0 %,P 0.01 , respec tively).Multivariate logistic regression analysis indicated that previous angina pectoris was an independent determinant of the risk of mortality(OR: 3.96 ,95% CI: 2.25 }7.34,P 0.05 ) and increase in combined endpoint events(OR: 3.22 ,95% CI: 1.82 8.74 ,P 0.05 ) in patients with AMI.Conclusion:The AMI patients with previous AP have extensive coronary artery lesions and poor clinical outcomes.