Association between preinfarction angina and coronary artery ectasia in the acute myocardial infarction

Abstract

Objective The objective of this study was to investigate the predictors of preinfarction angina (PA) and to show the association between PA and coronary ectasia (CE).

Methods A total of 222 patients with acute myocardial infarction were included. All patients were treated with primary coronary intervention and interviewed by the staff physicians within 24 h of presentation after reperfusion had succeeded. The patients were classified according to the presence of PA and CE. All groups were compared statistically according to their clinicodemographic characteristics and angiographic results. Regression analysis was performed to show the predictors of PA.

Results Half of the patients were defined as preinfarction angina (48.2 %) and the success rate of primary coronary intervention did not differ statistically in the PA present group. More than half of the patients had multivessel disease and coronary ectasia was found in the 11.7%. The right coronary artery (RCA) was the most common localization for ectasia and 61.5% of the ectatic vessels were also infarct-related. Diabetes mellitus, hypertension and previous coronary heart disease were slightly more common in the PA present group. In the regression analysis, coronary ectasia, multivessel disease and previously diagnosed coronary artery disease were independent predictors of PA (P= 0.001, P= 0.01 and P= 0.03, respectively)

Conclusions CE is more common in patients with PA and more than half of the patients showed CE in the infarct-related vessel. CE and multivessel disease are independent predictors of PA. The success rate of primary coronary intervention in ectatic infarct-related vessels did not diff er in the PA group.

Key Words:

• Preinfarction angina
• coronary ectasia
• myocardial infarction