COMPARISON OF OUTCOME OF PATIENTS HAVING FIRST ACUTE MYOCARDIAL INFARCTION WITH OR WITHOUT PRE-INFARCT ANGINA

Abstract

Objective: To compare outcome of patients having first acute myocardialinfarction with or without pre infarct angina.

Methodology: This cross sectional study was done in department of cardiologyin Chauhdary Pervaiz Elahi Institute of Cardiology Multan. Patients of acutemyocardial infarction (divided in two equal groups) were included in the study.Based on the history of preinfarct angina, patients were stratified into two equalgroups; group A patients who had pre-infarct angina and group B with no angina .Patients were admitted in the coronary care unit and were monitored with ECG forrhythm abnormalities, echocardiography for left ventricular systolic dysfunctionand in-hospital mortality.

Results: There were 200 patients included in this study. Mean age of the patientpopulation was 52.51 ± 6.37. There were 125 (62.5%) males and 75 (37.5%)females. Systolic dysfunction was identified in 6% in group A and 29% in group B(p < 0.0001, Odd's ratio of 6.399), arrhythmia in 12% patients in group A and33% in group B (p = 0.001, Odd's ratio of 3.612), mortality was present in 5%patients in group A and in 15% in group B (p = 0.032 and an Odd's ratio of 3.353).

Conclusion: Preinfarct angina was associated with an improved outcome inpatients with first MI as compared to those patients who never experiencedangina. This improved outcome was significant in all the three variables which westudied, i.e. arrhythmias, systolic dysfunction and mortality.