Key result
Antecedent angina within 7 days prior to PTCA significantly reduced the sum of ST elevation during balloon occlusion compared to no antecedent angina (1.18 vs 1.88 mV, p=0.0088).
Why the study?
Does antecedent angina reduce ischemic severity during coronary angioplasty in patients with stable angina?
Observational (n=42)
Does antecedent angina reduce ischemic severity during coronary angioplasty in patients with stable angina?
Antecedent angina within 7 days prior to PTCA provides a cellular protective effect against subsequent ischemia during balloon inflation, independent of collateral flow recruitment.
Answers are grounded in this paper and cite their sources.
Antecedent angina was associated with less ST elevation during PTCA; hypothesis-generating for preconditioning in stable angina.
The main aim of this study was to elucidate whether the beneficial effect of antecedent angina is a cellular protective effect or the result of an increase of collateral flow. Of 42 patients with angina who underwent percutaneous transluminal coronary angioplasty (PTCA) for proximal left anterior descending artery (LAD) stenosis, 22 had experienced antecedent anginal pain (AP) within 7 days prior to PTCA. 99mTc-sestamibi was injected during balloon inflation, and quantitative analysis of ischemic severity during coronary occlusion was calculated (SS). An electrocardiogram was recorded during ballooning to calculate the sum of ST elevation (sumST). SumST was significantly reduced in patients with AP compared with patients without AP (1.88+/-0.89 mV vs 1.18+/-0.74 mV, p=0.0088); however, no difference was observed in defect severity. A close correlation was observed between SS and sumST in both groups. The multivariate regression model demonstrated that both a large SS (p<0.0001) and the absence of preceding AP (p=0.001) were significantly related to the elevation of sumST. Recent angina can render the myocardium more resistant to subsequent ischemia during angioplasty and is true preconditioning rather than simply an increase of flow.
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Matsuo et al. (2002) conducted an observational in Angina undergoing PTCA for proximal LAD stenosis (n=42). Antecedent anginal pain within 7 days prior to PTCA vs. No antecedent anginal pain was evaluated on Sum of ST elevation (sumST) during ballooning (p=0.0088). Antecedent angina within 7 days prior to PTCA significantly reduced the sum of ST elevation during balloon occlusion compared to no antecedent angina (1.18 vs 1.88 mV, p=0.0088).
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