Absence of pre-angina before AMI was linked to significantly higher 30-day and long-term cardiovascular mortality in STEMI patients, but not NSTEMI patients.
Does the presence of pre-angina improve short- and long-term cardiovascular mortality in acute myocardial infarction patients?
The absence of pre-infarction angina is a negative prognostic marker associated with higher short- and long-term cardiovascular mortality, particularly in patients with STEMI.
Abstract Background Ischemic preconditioning has been associated with smaller infarct size and better clinical outcomes in patients with acute myocardial infarction (AMI). However, the association between pre-angina and long-term clinical outcomes after AMI is uncertain. Purpose The present study aimed to evaluate the impact of pre-angina on long-term cardiovascular outcomes in AMI patients. Methods Consecutive AMI patients who underwent primary percutaneous intervention between 1999 and 2015 were retrospectively analyzed. The primary endpoint was cardiovascular death up-to 5 years. We divided patients into two groups based on whether they had angina prior to the onset of AMI. Results Of the 2,159 AMI patients who had available information of prior symptoms, 1,101 patients (51.0%) had pre-angina. Patients without pre-angina were older and higher rate of ST elevated MI (STEMI). 30-day cardiovascular mortality was significantly higher in patients without pre-angina compared those with pre-angina among both STEMI and NSTEMI patients. Landmark Kaplan-Meier analysis showed that cardiovascular mortality after 30-day was significantly higher in patients without pre-angina among STEMI population, however, the cumulative incidence of cardiovascular death was not significantly different between two groups among NSTEMI population. Conclusions Absence of chest symptoms before AMI is associated with poor prognosis. Especially for STEMI patients, it is associated with both short- and long-term cardiovascular mortality.30-day cardiovascular mortality Land-mark analysis for cardiovascular de
Inaba et al. (2025) studied this question. Absence of pre-angina before AMI was linked to significantly higher 30-day and long-term cardiovascular mortality in STEMI patients, but not NSTEMI patients.