Clinical and angiographic factors including number of diseased vessels (p=0.0008), non-Q wave MI (p=0.0027), and previous angina (p=0.017) independently predicted early postinfarction ischemia.
Cohort (n=449)
What are the clinical and angiographic predictors of early postinfarction ischemia in patients surviving an acute MI?
Early postinfarction ischemia is independently predicted by the number of diseased vessels, presence of a non-Q wave MI, and previous angina, and is associated with more extensive angiographic disease.
Early ischemia, defined as angina with transient ST-T changes during hospitalization, 24 hr or more after an acute myocardial infarction (MI), was observed in 79 (18%) of a consecutive series of 449 patients surviving an MI and catheterized a mean of 10 +/- 3 days after admission. Three clinical factors present 24 hr after admission could identify patients at low, medium, and high risk of factors had a risk greater than 50% and the 118 patients with Q wave MI, no previous angina, and absence of risk factors had a risk of less than 8%. The angiographic correlates of early ischemia were number of vessels with 70% or more stenosis (2.1 +/- 0.8 vs 1.7 +/- 0.8/patient, p less than .0001), number of diseased coronary artery segments (2.8 +/- 1.4 vs 2.1 +/- 1.2, p less than .0001), left anterior descending coronary involvement (77% vs 62% of patients, p = .01), number of normally contractile segments at jeopardy because of a coronary stenosis (1.9 +/- 1.3 vs 1.3 +/- 1.1/patient, p less than .0002), collateral circulation at jeopardy (24% vs 15% of patients, p less than .005), and fewer collateral vessels distal to a tight stenosis (59 vs 72% of patients, p = .04). The stepwise logistic regression retained one angiographic and two clinical independent predictors of early ischemia: number of diseased vessels (p = .0008), presence of a non-Q wave MI (p = .0027), and previous angina (p = .017).(ABSTRACT TRUNCATED AT 250 WORDS)
Bosch et al. (Fri,) conducted a cohort in Acute myocardial infarction (n=449). Clinical and angiographic factors was evaluated on Early ischemia. Clinical and angiographic factors including number of diseased vessels (p=0.0008), non-Q wave MI (p=0.0027), and previous angina (p=0.017) independently predicted early postinfarction ischemia.