Abstract
<h3>Objective</h3> To evaluate myocardial necrosis extent after myocardial infarction (MI) and reperfusion with primary coronary angioplasty in nondiabetic patients and the relationship with unstable preinfarction angina (PA) <h3>Design</h3> Prospective cohort study <h3>Setting</h3> Studies suggest PA limits infarct size. This effect is questioned in patients treated with primary coronary angioplasty <h3>Patients</h3> Seventy-eight, nondiabetic, consecutive MI patients <h3>Interventions</h3> Primary coronary angioplasty and scintigraphic study to assess the myocardial infarct size <h3>Main outcome measures</h3> Scintigraphic myocardial infarct size <h3>Results</h3> There were 32 patients with PA (PA +) and 46 without PA (PA −) in the 24-h period prior to MI onset. There were no significant differences in the baseline characteristics between the two groups. The scintigraphy indicated myocardial infarct size significantly smaller in PA + patients: mean, 18.0% (SD, 14.7) vs 27.0% (SD, 20.1) [p = 0.033]. This occurs even though Thrombolysis in Myocardial Infarction grade 3 flow achieved in both groups was similar (84.8% vs 84.4%, p=1.000). We found a higher percentage of ST-segment resolution (≥ 70%) in PA + patients (65.6% vs 45.7%, p=0.082) together with a lower incidence of left ventricular systolic dysfunction (3.2% vs 18.6%, p=0.071) <h3>Conclusions</h3> PA exerts a beneficial effect in nondiabetic patients with ST-segment elevation acute MI even when treated with primary PCI. The infarct size is limited, and left ventricular systolic function is preserved. The effects may be related to a better preservation of tissue reperfusion in patients with PA
Published Version
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