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

Abstract

Abstract 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.