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Recurrence of angina after ST-segment elevation myocardial infarction: the role of coronary microvascular obstruction.
Montone, Rocco A; Vetrugno, Vincenzo; Santacroce, Giovanni; Del Buono, Marco Giuseppe; Meucci, Maria Chiara; Camilli, Massimiliano; Galli, Mattia; Leone, Antonio M; D'Amario, Domenico; Buffon, Antonio; Aurigemma, Cristina; Burzotta, Francesco; Trani, Carlo; Niccoli, Giampaolo; Crea, Filippo.
Afiliação
  • Montone RA; Department of Cardiovascular and Thoracic Sciences, Fondazione Policlinico Universitario A Gemelli IRCCS, Italy.
  • Vetrugno V; Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy.
  • Santacroce G; Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy.
  • Del Buono MG; Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy.
  • Meucci MC; Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy.
  • Camilli M; Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy.
  • Galli M; Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy.
  • Leone AM; Department of Cardiovascular and Thoracic Sciences, Fondazione Policlinico Universitario A Gemelli IRCCS, Italy.
  • D'Amario D; Department of Cardiovascular and Thoracic Sciences, Fondazione Policlinico Universitario A Gemelli IRCCS, Italy.
  • Buffon A; Department of Cardiovascular and Thoracic Sciences, Fondazione Policlinico Universitario A Gemelli IRCCS, Italy.
  • Aurigemma C; Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy.
  • Burzotta F; Department of Cardiovascular and Thoracic Sciences, Fondazione Policlinico Universitario A Gemelli IRCCS, Italy.
  • Trani C; Department of Cardiovascular and Thoracic Sciences, Fondazione Policlinico Universitario A Gemelli IRCCS, Italy.
  • Niccoli G; Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy.
  • Crea F; Department of Cardiovascular and Thoracic Sciences, Fondazione Policlinico Universitario A Gemelli IRCCS, Italy.
Eur Heart J Acute Cardiovasc Care ; : 2048872619880661, 2019 Oct 16.
Article em En | MEDLINE | ID: mdl-31617387
BACKGROUND: The recurrence of angina after percutaneous coronary intervention affects 20-35% of patients with stable coronary artery disease; however, few data are available in the setting of ST-segment elevation myocardial infarction. We evaluated the relation between coronary microvascular obstruction and the recurrence of angina at follow-up. METHODS: We prospectively enrolled patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. Microvascular obstruction was defined as thrombolysis in myocardial infarction flow less than 3 or 3 with myocardial blush grade less than 2. The primary endpoint was the recurrence of angina at follow-up. Moreover, angina status was evaluated by the Seattle angina questionnaire summary score (SAQSS). Therapy at follow-up and the occurrence of major adverse cardiovascular events were also collected. RESULTS: We enrolled 200 patients. Microvascular obstruction occurred in 52 (26%) of them. Follow-up (mean time 25.17±9.28 months) was performed in all patients. Recurrent angina occurred in 31 (15.5%) patients, with a higher prevalence in patients with microvascular obstruction compared with patients without microvascular obstruction (13 (25.0%) vs. 18 (12.2%), P=0.008). Accordingly, SAQSS was lower and the need for two or more anti-anginal drugs was higher in patients with microvascular obstruction compared with patients without microvascular obstruction. At multiple linear regression analysis a history of previous acute coronary syndrome and the occurrence of microvascular obstruction were the only independent predictors of a worse SAQSS. Finally, the occurrence of major adverse cardiovascular events was higher in patients with microvascular obstruction compared with patients without microvascular obstruction. CONCLUSIONS: The recurrence of angina in ST-segment elevation myocardial infarction patients treated with primary percutaneous coronary intervention is an important clinical issue. The occurrence of microvascular obstruction portends a worse angina status and is associated with the use of more anti-anginal drugs.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Prognostic_studies / Risk_factors_studies Idioma: En Ano de publicação: 2019 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Prognostic_studies / Risk_factors_studies Idioma: En Ano de publicação: 2019 Tipo de documento: Article