Impact of pre-infarction angina on angiographic and echocardiographic outcomes in patients with acute anterior wall myocardial infarction managed by primary percutaneous coronary intervention

Objectives: To assess the impact of angina prior to first attack of acute anterior wall ST-segment elevation myocardial infarction (STEMI) on immediate angiographic and echocardiographic outcomes after primary percutaneous coronary intervention (PPCI). Methods: A total of 100 patients with acute anterior wall STEMI managed by PPCI were included (50 patients with pre-infarction angina (PIA) and 50 patients without). Patients were observed for angiographic outcome (coronary collateral grade, final TIMI and TMP flow grade) and echocardiographic outcome. Results: Baseline patient characteristics were similar in both groups. PIA group had more patients with grade 3 coronary collaterals (p = 0.006), more patients with TIMI 3 flow grade after PPCI (p = 0.0002), less patients with TMP 0 flow grade (p = 0.013). The group with no PIA had more advanced Killip class at presentation (p = 0.015). No difference was present between both groups regarding post-PPCI LV ejection fraction (p = 0.255), LV end diastolic dimensions (p = 0.553), LV end systolic dimensions (p = 0.908), segmental wall motion score index (p = 0.214). Conclusions: For patients suffering from a first attack of acute anterior wall STEMI, pre-infarction angina is associated with a better Killip class at presentation, better TIMI flow grade after PPCI, less incidence of TMP 0 flow grade.