Beneficial Effect of Preinfarction Angina on In-Hospital Outcome is Preserved in Elderly Patients Undergoing Coronary Intervention for Anterior Acute Myocardial Infarction

Abstract

Background Preinfarction angina improves survival after acute myocardial infarction (AMI) in nonelderly but not elderly patients in the thrombolytic era. However, it remains unclear whether preinfarction angina has a beneficial effect on clinical outcome in elderly patients undergoing percutaneous coronary intervention (PCI). Methods and Results The study group comprised 484 anterior AMI patients who were admitted within 24 h of onset and underwent emergency PCI. Patients were divided into 2 groups: those aged <70 years (nonelderly patients, n=290) and those aged ≥70 years (elderly patients, n=194). Angina within 24 h before AMI was present in 42% of nonelderly patients and in 37% of elderly patients. In nonelderly patients, preinfarction angina was associated with a lower in-hospital mortality rate (1% vs 7%, p=0.02). Similarly, in elderly patients, preinfarction angina was associated with a lower in-hospital mortality rate (6% vs 16%, p=0.03). Multivariate analysis showed that the absence of preinfarction angina was an independent predictor of in-hospital mortality in both nonelderly (odds ratio 4.20; 95% confidence interval (CI) 1.20-10.6; p=0.04) and elderly patients (odds ratio 3.04; 95%CI 1.06-18.1; p=0.04). Conclusions Angina within the 24 h before AMI is associated with better in-hospital outcomes in elderly and nonelderly patients. (Circ J 2005; 69: 630 - 635)