V.Y. Tseluyko, T.A. Lozova, V.M. Dominas Effect of previous angina pectoris upon prognosis in patients with right ventricular myocardial infarction on the background of the posterior Q-wave myocardial infarction

The aim – to evaluate impact of the previous angina pectoris (AP) on risk of complications during acute period and long-term prognosis of patients with right ventricular (RV) myocardial infarction (MI) on the background of the posterior Q-wave MI.

Material and methods. 155 patients with RV MI aged 64.11±0.78 years were evaluated. The 1st group – 97 (62.6 %) patients had chronic AP before MI, and the 2nd group – 58 (37.4 %) patients – without previous AP. Average follow-up was 30±4.5 months. Endpoints were: unstable angina (UA), recurrent MI (Re-MI), stroke, cardiovascular (CV) death and HF-hospitalizations.

Results. Patients with AP differed had older age (Р=0.005), greater frequency of diabetes mellitus (Р=0.017) and hypertension (Р=0.0013). In the acute period of the RV MI in the 1st group there was higher incidence of ventricular extrasystoles (Р=0.047), high-degree and complete AV-blockade (Р=0.023), acute HF (Killip II–III) (Р=0.017; Р=0.011), and postinfarction angina (Р=0.002). Study endpoints occurred in 65 (41.9 %) patients: UA – 50 (32.2 %), Re-MI – 15 (9.6 %), stroke – 9 (5.8 %), CV-death – 16 (10.3 %), HF-hospitalization – 22 (14.2 %). The frequency of HF-hospitalization (Р=0.013), UA (Р=0.0001), Re-MI (Р=0.025 and CV-death (Р=0.0065) were significantly higher in the 1st group. After 30-month follow-up the CV-events occurred in 51 (52.6 %) patients with previous AP when compared with 14 (24.1 %) patients in the 2nd group (Cox F-Test: Р=0.00001).

Conclusions. The chronic AP previous RV MI is associated with significant increase of the risk CV-complications, in particular, CV-death, Re-MI, UA and HF-hospitalizations during 30-months follow-up.

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