Pre-infarction Angina: Time Interval to Onset of Myocardial Infarction and Comorbidity Predictors

Abstract

AimsAs part of efforts to identify candidates for patient education aimed at decreasing mortality from acute myocardial infarction, we investigated the prevalence of pre-infarction angina and its predictors among comorbidities in patients who were hospitalized with acute myocardial infarction (MI).MethodsWe conducted a prospective multicenter observational registry of MI patients from 1998 to 2014 (N = 12,093). The present study investigated the prevalence of pre-infarction angina and its predictors among comorbidities with a logistic regression model. Pre-infarction angina was defined as chest pain/oppression observed within 1 month before the onset of MI but which lasted <30 min.ResultsAfter excluding 976 (8.1%) patients with missing data on pre-infarction angina, 11,117 patients [66.4 ± 12.0 years, 9,096 (75.2%) male] were analyzed. Of these, 5,428 patients (48.8%) experienced pre-infarction angina before the onset of MI, while 5,689 (51.2%) experienced sudden onset of acute MI. Most patients experienced the first episode of angina >6 h before the onset of MI, while 15% did so ≤6 h before. Patients with hypertension, diabetes, dyslipidemia, or a family history of MI had a higher probability of pre-infarction angina than those without. Elderly patients and those with a history of cerebrovascular disease were less likely to experience pre-infarction angina.ConclusionsAlmost half of MI patients in our registry experienced pre-infarction angina before MI onset. Patients with hypertension, diabetes, dyslipidemia, or a family history of MI had a higher probability of experiencing pre-infarction angina than those without.

Individual acute-phase bleeding and thrombotic risk balance assessment in patients undergoing percutaneous coronary intervention for acute myocardial infarction

“…This study is a post-hoc subanalysis of the Osaka Acute Coronary Insufficiency Study (OACIS) database (N = 12,093) (UMIN000004575). The OACIS is a prospective, multicenter cohort study designed to collect and analyze demographic, procedural and outcome data in patients with STEMI/NSTEMI at 25 collaborating hospitals with cardiac emergency units [11] , [12] . A diagnosis of acute MI was made if the patient fulfilled at least 2 of the following 3 criteria: (1) history of central chest pressure, pain, or tightness lasting ≥30 min, (2) typical ECG changes (i.e., ST-segment elevation ≥0.1 mV in 1 standard limb lead or 2 precordial leads, ST-segment depression ≥0.1 mV in 2 leads, abnormal Q waves, or T-wave inversion in 2 leads), and (3) a rise in serum creatinine phosphokinase concentration to more than twice the normal laboratory value [13] , [14] .…”

Association of Wide Pulse Pressure with Coronary Collateral Flow in Patients with ST- Elevation Myocardial Infarction Undergoing Percutaneous Coronary Intervention

“…The manifestation of acute myocardial infarction was classi ed according to the Killip classi cation: Killip I, no evidence of heart failure; Killip II: heart failure; Killip III, severe heart failure or acute pulmonary edema; Killip IV, cardiogenic shock [19]. Chest discomfort or pain occurring within one month before a myocardial infarction, lasting for less than 30 minutes, was classi ed as pre-infarction angina [20].…”