Angina Pectoris Early after Myocardial Infarction: Clinical Experience of the Multicentre Post-Infarction Program

In the Multicenter Post Infarction Program, 33% of 867 patients had early angina pectoris, i.e. angina between 2 days and hospital discharge 17 +/- 9 days after infarction. Early post-infarction angina was not significantly associated with cardiac death during 2.5 years of follow-up whereas both ventricular arrhythmias and left ventricular dysfunction were strongly and independently related to subsequent mortality. After myocardial infarction, there is no significant association between early angina pectoris and either ventricular arrhythmias or systolic or diastolic dysfunction of the left ventricle. However, patients with early post-infarction angina were one-and-a-half times as likely to be rehospitalized and two-and-a-half times as likely to experience recurrent non-fatal myocardial infarction during the year after myocardial infarction. Exercise angina pectoris was associated with subsequent mortality but not with recurrent non-fatal myocardial infarction. ST segment depression greater than or equal to 1 mm or greater than or equal to 2 mm during exercise was not significantly associated with either subsequent death or non-fatal myocardial infarction.