Prodromal angina is associated with myocardial salvage in acute ST-segment elevation myocardial infarction

Pier Giorgio Masci, Daniele Andreini, Marco Francone, Erika Bertella, Laura De Luca, Michele Coceani, Saima Mushtaq, Massimiliano Mariani, Iacopo Carbone, Gianluca Pontone, Luciano Agati, Jan Bogaert, Massimo Lombardi

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

AimsPrevious studies have shown that prodromal angina (PA) occurs frequently in acute myocardial infarction (MI) patients. However, the potential benefits of PA on ischaemic myocardial damage remain unknown.Methods and resultsOne-hundred and fifty-four patients with acute ST-segment elevation MI successfully treated with primary percutaneous coronary intervention (PPCI) were prospectively evaluated for new-onset PA in the week preceding infarction and other factors known to influence myocardial salvage. Cardiovascular magnetic resonance was performed 8 ± 3 days after MI for the assessment of area-at-risk (AAR), MI size, myocardial haemorrhage (MH), microvascular obstruction (MO), and myocardial salvage index (MSI).Patients with PA (n = 60) compared with those without PA (n = 94) showed similar AAR but significantly smaller MI size leading to larger MSI (0.53 ± 0.27 vs. 0.32 ± 0.26, P <0.001). Additionally, patients with PA had lower incidence of MH (18 vs. 33%) and MO (22 vs. 46%) than non-PA patients (both P <0.05). At univariate analysis, higher MSI was associated with new-onset PA, lower myocardial oxygen consumption before PPCI, shorter time-to-PPCI, and higher post-procedural TIMI flow-grade. Neither collateral circulation nor medications administered before PPCI were associated to MSI. After correction for other covariates by multivariate analysis, new-onset PA remained significantly associated with MSI (β-value: 0.352, P <0.001).ConclusionIn acute MI patients, new-onset PA is associated with higher MSI independent of others factors known to influence jeopardized myocardium, as well as with less microvascular damage.

Original languageEnglish
Pages (from-to)1041-1048
Number of pages8
JournalEuropean Heart Journal Cardiovascular Imaging
Volume14
Issue number11
DOIs
Publication statusPublished - Nov 2013

Fingerprint

Percutaneous Coronary Intervention
Myocardial Infarction
Hemorrhage
Collateral Circulation
Oxygen Consumption
Infarction
ST Elevation Myocardial Infarction
Myocardium
Magnetic Resonance Spectroscopy
Multivariate Analysis
Incidence

Keywords

  • Cardioprotection
  • Myocardial infarction
  • Prodromal angina

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

Cite this

Prodromal angina is associated with myocardial salvage in acute ST-segment elevation myocardial infarction. / Masci, Pier Giorgio; Andreini, Daniele; Francone, Marco; Bertella, Erika; De Luca, Laura; Coceani, Michele; Mushtaq, Saima; Mariani, Massimiliano; Carbone, Iacopo; Pontone, Gianluca; Agati, Luciano; Bogaert, Jan; Lombardi, Massimo.

In: European Heart Journal Cardiovascular Imaging, Vol. 14, No. 11, 11.2013, p. 1041-1048.

Research output: Contribution to journalArticle

Masci, PG, Andreini, D, Francone, M, Bertella, E, De Luca, L, Coceani, M, Mushtaq, S, Mariani, M, Carbone, I, Pontone, G, Agati, L, Bogaert, J & Lombardi, M 2013, 'Prodromal angina is associated with myocardial salvage in acute ST-segment elevation myocardial infarction', European Heart Journal Cardiovascular Imaging, vol. 14, no. 11, pp. 1041-1048. https://doi.org/10.1093/ehjci/jet063
Masci, Pier Giorgio ; Andreini, Daniele ; Francone, Marco ; Bertella, Erika ; De Luca, Laura ; Coceani, Michele ; Mushtaq, Saima ; Mariani, Massimiliano ; Carbone, Iacopo ; Pontone, Gianluca ; Agati, Luciano ; Bogaert, Jan ; Lombardi, Massimo. / Prodromal angina is associated with myocardial salvage in acute ST-segment elevation myocardial infarction. In: European Heart Journal Cardiovascular Imaging. 2013 ; Vol. 14, No. 11. pp. 1041-1048.
@article{75c77a7f79984a7f9f757c45a047d1ee,
title = "Prodromal angina is associated with myocardial salvage in acute ST-segment elevation myocardial infarction",
abstract = "AimsPrevious studies have shown that prodromal angina (PA) occurs frequently in acute myocardial infarction (MI) patients. However, the potential benefits of PA on ischaemic myocardial damage remain unknown.Methods and resultsOne-hundred and fifty-four patients with acute ST-segment elevation MI successfully treated with primary percutaneous coronary intervention (PPCI) were prospectively evaluated for new-onset PA in the week preceding infarction and other factors known to influence myocardial salvage. Cardiovascular magnetic resonance was performed 8 ± 3 days after MI for the assessment of area-at-risk (AAR), MI size, myocardial haemorrhage (MH), microvascular obstruction (MO), and myocardial salvage index (MSI).Patients with PA (n = 60) compared with those without PA (n = 94) showed similar AAR but significantly smaller MI size leading to larger MSI (0.53 ± 0.27 vs. 0.32 ± 0.26, P <0.001). Additionally, patients with PA had lower incidence of MH (18 vs. 33{\%}) and MO (22 vs. 46{\%}) than non-PA patients (both P <0.05). At univariate analysis, higher MSI was associated with new-onset PA, lower myocardial oxygen consumption before PPCI, shorter time-to-PPCI, and higher post-procedural TIMI flow-grade. Neither collateral circulation nor medications administered before PPCI were associated to MSI. After correction for other covariates by multivariate analysis, new-onset PA remained significantly associated with MSI (β-value: 0.352, P <0.001).ConclusionIn acute MI patients, new-onset PA is associated with higher MSI independent of others factors known to influence jeopardized myocardium, as well as with less microvascular damage.",
keywords = "Cardioprotection, Myocardial infarction, Prodromal angina",
author = "Masci, {Pier Giorgio} and Daniele Andreini and Marco Francone and Erika Bertella and {De Luca}, Laura and Michele Coceani and Saima Mushtaq and Massimiliano Mariani and Iacopo Carbone and Gianluca Pontone and Luciano Agati and Jan Bogaert and Massimo Lombardi",
year = "2013",
month = "11",
doi = "10.1093/ehjci/jet063",
language = "English",
volume = "14",
pages = "1041--1048",
journal = "European Heart Journal Cardiovascular Imaging",
issn = "2047-2404",
publisher = "Oxford University Press",
number = "11",

}

TY - JOUR

T1 - Prodromal angina is associated with myocardial salvage in acute ST-segment elevation myocardial infarction

AU - Masci, Pier Giorgio

AU - Andreini, Daniele

AU - Francone, Marco

AU - Bertella, Erika

AU - De Luca, Laura

AU - Coceani, Michele

AU - Mushtaq, Saima

AU - Mariani, Massimiliano

AU - Carbone, Iacopo

AU - Pontone, Gianluca

AU - Agati, Luciano

AU - Bogaert, Jan

AU - Lombardi, Massimo

PY - 2013/11

Y1 - 2013/11

N2 - AimsPrevious studies have shown that prodromal angina (PA) occurs frequently in acute myocardial infarction (MI) patients. However, the potential benefits of PA on ischaemic myocardial damage remain unknown.Methods and resultsOne-hundred and fifty-four patients with acute ST-segment elevation MI successfully treated with primary percutaneous coronary intervention (PPCI) were prospectively evaluated for new-onset PA in the week preceding infarction and other factors known to influence myocardial salvage. Cardiovascular magnetic resonance was performed 8 ± 3 days after MI for the assessment of area-at-risk (AAR), MI size, myocardial haemorrhage (MH), microvascular obstruction (MO), and myocardial salvage index (MSI).Patients with PA (n = 60) compared with those without PA (n = 94) showed similar AAR but significantly smaller MI size leading to larger MSI (0.53 ± 0.27 vs. 0.32 ± 0.26, P <0.001). Additionally, patients with PA had lower incidence of MH (18 vs. 33%) and MO (22 vs. 46%) than non-PA patients (both P <0.05). At univariate analysis, higher MSI was associated with new-onset PA, lower myocardial oxygen consumption before PPCI, shorter time-to-PPCI, and higher post-procedural TIMI flow-grade. Neither collateral circulation nor medications administered before PPCI were associated to MSI. After correction for other covariates by multivariate analysis, new-onset PA remained significantly associated with MSI (β-value: 0.352, P <0.001).ConclusionIn acute MI patients, new-onset PA is associated with higher MSI independent of others factors known to influence jeopardized myocardium, as well as with less microvascular damage.

AB - AimsPrevious studies have shown that prodromal angina (PA) occurs frequently in acute myocardial infarction (MI) patients. However, the potential benefits of PA on ischaemic myocardial damage remain unknown.Methods and resultsOne-hundred and fifty-four patients with acute ST-segment elevation MI successfully treated with primary percutaneous coronary intervention (PPCI) were prospectively evaluated for new-onset PA in the week preceding infarction and other factors known to influence myocardial salvage. Cardiovascular magnetic resonance was performed 8 ± 3 days after MI for the assessment of area-at-risk (AAR), MI size, myocardial haemorrhage (MH), microvascular obstruction (MO), and myocardial salvage index (MSI).Patients with PA (n = 60) compared with those without PA (n = 94) showed similar AAR but significantly smaller MI size leading to larger MSI (0.53 ± 0.27 vs. 0.32 ± 0.26, P <0.001). Additionally, patients with PA had lower incidence of MH (18 vs. 33%) and MO (22 vs. 46%) than non-PA patients (both P <0.05). At univariate analysis, higher MSI was associated with new-onset PA, lower myocardial oxygen consumption before PPCI, shorter time-to-PPCI, and higher post-procedural TIMI flow-grade. Neither collateral circulation nor medications administered before PPCI were associated to MSI. After correction for other covariates by multivariate analysis, new-onset PA remained significantly associated with MSI (β-value: 0.352, P <0.001).ConclusionIn acute MI patients, new-onset PA is associated with higher MSI independent of others factors known to influence jeopardized myocardium, as well as with less microvascular damage.

KW - Cardioprotection

KW - Myocardial infarction

KW - Prodromal angina

UR - http://www.scopus.com/inward/record.url?scp=84885921320&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84885921320&partnerID=8YFLogxK

U2 - 10.1093/ehjci/jet063

DO - 10.1093/ehjci/jet063

M3 - Article

C2 - 23793878

AN - SCOPUS:84885921320

VL - 14

SP - 1041

EP - 1048

JO - European Heart Journal Cardiovascular Imaging

JF - European Heart Journal Cardiovascular Imaging

SN - 2047-2404

IS - 11

ER -