From Good Samaritan Hospital, Los Angeles, Calif (R.A.K., T.S., K.P.);
the University of Southern California, Los Angeles (R.A.K., K.P.); Brigham and
Womens Hospital and Harvard Medical School, Boston, Mass (E.M.A., C.P.C.,
C.H.M., E.B.); and Covance Inc, Princeton, NJ (K.Y.).
Correspondence to Robert A. Kloner, MD, PhD, Heart Institute, Good Samaritan Hospital, 1225 Wilshire Blvd, Los Angeles, CA 90017.
Background—The timing of onset of
angina before myocardial infarction in relation to outcome is
unknown.
Methods and Results—We prospectively determined the importance of
the time of onset of preinfarction angina in relation to 30-day
outcomes in the TIMI-9B study from standardized forms. Of the 3002
patients entered into the study, 425 reported angina before their
myocardial infarction. Patients with angina onset within 24 hours of
infarction had a lower 30-day cardiac event rate (mortality, recurrent
myocardial infarction, heart failure, or shock) at 4% than those with
onset of angina >24 hours (17%; P=.030). A history of
any angina alone was not associated with reduced event rate. Peak
creatine kinase levels tended to be lower in the group with angina
within 24 hours. These benefits were not due to higher rates of use of
antianginal medicines or aspirin and were not a consequence of
differences in baseline characteristics or disease states
(hypertension, hypercholesterolemia) among
subgroups.
Conclusions—These temporal observations are consistent
with the concept of preconditioning by preinfarction angina but do not
rule out other mechanisms.
© 1998 American Heart Association, Inc.
Clinical Investigation and Reports
Prospective Temporal Analysis of the Onset of Preinfarction Angina Versus Outcome
An Ancillary Study in TIMI-9B
Key Words: angina • myocardial infarction • trials
This article has been cited by other articles:
 |
|
 |
|
  G. Ambrosio, M. Del Pinto, I. Tritto, G. Agnelli, M. Bentivoglio, C. Zuchi, F. A. Anderson, J. M. Gore, J. Lopez-Sendon, A. Wyman, et al. Chronic nitrate therapy is associated with different presentation and evolution of acute coronary syndromes: insights from 52 693 patients in the Global Registry of Acute Coronary Events Eur. Heart J., November 10, 2009; (2009) ehp457v1. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. A. Kloner Clinical Application of Remote Ischemic Preconditioning Circulation, February 17, 2009; 119(6): 776 - 778. [Full Text] [PDF]
|
|
|
|
|
|
H. Ishii, T. Amano, T. Matsubara, and T. Murohara Pharmacological Intervention for Prevention of Left Ventricular Remodeling and Improving Prognosis in Myocardial Infarction Circulation, December 16, 2008; 118(25): 2710 - 2718. [Full Text] [PDF]
|
|
|
|
 |
|
 R. M. Mentzer Jr, M. S. Jahania, and R. D. Lasley Myocardial Protection Card. Surg. Adult, January 1, 2008; 3(2008): 443 - 464. [Full Text]
|
|
|
|
 |
|
 P. Ferdinandy, R. Schulz, and G. F. Baxter Interaction of Cardiovascular Risk Factors with Myocardial Ischemia/Reperfusion Injury, Preconditioning, and Postconditioning Pharmacol. Rev., December 1, 2007; 59(4): 418 - 458. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. K. Nallamothu, E. H. Bradley, and H. M. Krumholz Time to Treatment in Primary Percutaneous Coronary Intervention N. Engl. J. Med., October 18, 2007; 357(16): 1631 - 1638. [Full Text] [PDF]
|
|
|
|
|
|
A. Schomig, G. Ndrepepa, and A. Kastrati Late myocardial salvage: time to recognize its reality in the reperfusion therapy of acute myocardial infarction Eur. Heart J., August 2, 2006; 27(16): 1900 - 1907. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. A. Kloner Moving Preconditioning From Bench to Bedside J. Am. Coll. Cardiol., July 4, 2006; 48(1): 215 - 216. [Full Text] [PDF]
|
|
|
|
 |
|
 R. A. Kloner and S. H. Rezkalla Preconditioning, postconditioning and their application to clinical cardiology Cardiovasc Res, May 1, 2006; 70(2): 297 - 307. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. J. Domenech Preconditioning: A New Concept About the Benefit of Exercise Circulation, January 3, 2006; 113(1): e1 - e3. [Full Text] [PDF]
|
|
|
|
 |
|
 J. Frassdorf, N. C. Weber, D. Obal, O. Toma, J. Mullenheim, G. Kojda, B. Preckel, and W. Schlack Morphine Induces Late Cardioprotection in Rat Hearts In Vivo: The Involvement of Opioid Receptors and Nuclear Transcription Factor {kappa}B Anesth. Analg., October 1, 2005; 101(4): 934 - 941. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Schomig, J. Mehilli, D. Antoniucci, G. Ndrepepa, C. Markwardt, F. Di Pede, S. G. Nekolla, K. Schlotterbeck, H. Schuhlen, J. Pache, et al. Mechanical Reperfusion in Patients With Acute Myocardial Infarction Presenting More Than 12 Hours From Symptom Onset: A Randomized Controlled Trial JAMA, June 15, 2005; 293(23): 2865 - 2872. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Ottani, M. Galli, S. Zerboni, and M. Galvani Prodromal Angina Limits Infarct Size in the Setting of Acute Anterior Myocardial Infarction Treated With Primary Percutaneous Intervention J. Am. Coll. Cardiol., May 3, 2005; 45(9): 1545 - 1547. [Full Text] [PDF]
|
|
|
|
 |
|
 I. Iglesias-Garriz, F. Fernandez-Vazquez, A. Perez, J. Jimenez-Bonilla, C. Garrote, P. Uriarte, and C. DelaFuente Preinfarction Angina Limits Myocardial Infarction Size in Nondiabetic Patients Treated With Primary Coronary Angioplasty Chest, April 1, 2005; 127(4): 1116 - 1121. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Pasupathy and S. Homer-Vanniasinkam Surgical Implications of Ischemic Preconditioning Arch Surg, April 1, 2005; 140(4): 405 - 409. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Z.H. Rittersma, A. C. van der Wal, K. T. Koch, J. J. Piek, J. P.S. Henriques, K. J. Mulder, J. P.H.M. Ploegmakers, M. Meesterman, and R. J. de Winter Plaque Instability Frequently Occurs Days or Weeks Before Occlusive Coronary Thrombosis: A Pathological Thrombectomy Study in Primary Percutaneous Coronary Intervention Circulation, March 8, 2005; 111(9): 1160 - 1165. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. A. Rongen, W. J.G. Oyen, B. P. Ramakers, N. P. Riksen, O. C. Boerman, N. Steinmetz, and P. Smits Annexin A5 Scintigraphy of Forearm as a Novel In Vivo Model of Skeletal Muscle Preconditioning in Humans Circulation, January 18, 2005; 111(2): 173 - 178. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Inagaki, R. Begley, F. Ikeno, and D. Mochly-Rosen Cardioprotection by {epsilon}-Protein Kinase C Activation From Ischemia: Continuous Delivery and Antiarrhythmic Effect of an {epsilon}-Protein Kinase C-Activating Peptide Circulation, January 4, 2005; 111(1): 44 - 50. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Vogt, I. Portig, B. Kusch, S. Pankuweit, A. S. Sirat, D. Troitzsch, B. Maisch, and R. Moosdorf Detection of anti-hsp70 immunoglobulin G antibodies indicates better outcome in coronary artery bypass grafting patients suffering from severe preoperative angina Ann. Thorac. Surg., September 1, 2004; 78(3): 883 - 889. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. D. Solomon, N. S. Anavekar, S. Greaves, J. L. Rouleau, C. Hennekens, M. A. Pfeffer, and HEART Investigators Angina pectoris prior to myocardial infarction protects against subsequent left ventricular remodeling J. Am. Coll. Cardiol., May 5, 2004; 43(9): 1511 - 1514. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. A. Amsterdam and S. Schaefer Ischemic preconditioning in coronary heart disease: a therapeutic golden fleece? J. Am. Coll. Cardiol., May 5, 2004; 43(9): 1515 - 1516. [Full Text] [PDF]
|
|
|
|
|
|
M. Loubani, A. Hassouna, and M. Galinanes Delayed preconditioning of the human myocardium: signal transduction and clinical implications Cardiovasc Res, February 15, 2004; 61(3): 600 - 609. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. Tomoda and N. Aoki Coronary Blood Flow in Evolving Myocardial Infarction Preceded by Preinfarction Angina: A Critical Reevaluation of Preconditioning Effects in Clinical Cases Angiology, January 1, 2004; 55(1): 9 - 15. [Abstract] [PDF]
|
|
|
|
 |
|
 D. M. YELLON and J. M. DOWNEY Preconditioning the Myocardium: From Cellular Physiology to Clinical Cardiology Physiol Rev, October 1, 2003; 83(4): 1113 - 1151. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Miura Myocardial response to ischemic preconditioning: is it a novel predictor of prognosis? J. Am. Coll. Cardiol., September 17, 2003; 42(6): 1004 - 1006. [Full Text] [PDF]
|
|
|
|
 |
|
 E J P Lamfers, T E H Hooghoudt, D P Hertzberger, A Schut, P W J Stolwijk, and F W A Verheugt Abortion of acute ST segment elevation myocardial infarction after reperfusion: incidence, patients' characteristics, and prognosis Heart, May 1, 2003; 89(5): 496 - 501. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. M. Mentzer Jr., M. S. Jahania, and R. D. Lasley Myocardial Protection Card. Surg. Adult, January 1, 2003; 2(2003): 413 - 438. [Full Text]
|
|
|
|
 |
|
 E. G. Lakatta and S. J. Sollott The "Heartbreak" of Older Age Mol. Interv., November 1, 2002; 2(7): 431 - 446. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. A Kloner, M. T Speakman, and K. Przyklenk Ischemic preconditioning: a plea for rationally targeted clinical trials Cardiovasc Res, August 15, 2002; 55(3): 526 - 533. [Full Text] [PDF]
|
|
|
|
|
|
R. A. Kloner and R. B. Jennings Consequences of Brief Ischemia: Stunning, Preconditioning, and Their Clinical Implications: Part 2 Circulation, December 18, 2001; 104(25): 3158 - 3167. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. J. Gheeraert, J. P. S. Henriques, M. L. De Buyzere, M. De Pauw, Y. Taeymans, and F. Zijlstra Preinfarction angina protects against out-of-hospital ventricular fibrillation in patients with acute occlusion of the left coronary artery J. Am. Coll. Cardiol., November 1, 2001; 38(5): 1369 - 1374. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Ishihara, I. Inoue, T. Kawagoe, Y. Shimatani, S. Kurisu, K. Nishioka, Y. Kouno, T. Umemura, S. Nakamura, and H. Sato Diabetes mellitus prevents ischemic preconditioning in patients with a first acute anterior wall myocardial infarction J. Am. Coll. Cardiol., October 1, 2001; 38(4): 1007 - 1011. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Tomoda and N. Aoki Pathophysiology of Early Coronary Angioplasty with Stenting on Non-Q-Wave vs Q-Wave Myocardial Infarction Angiology, October 1, 2001; 52(10): 671 - 679. [Abstract] [PDF]
|
|
|
|
|
|
G. Heusch Nitroglycerin and Delayed Preconditioning in Humans : Yet Another New Mechanism for an Old Drug? Circulation, June 19, 2001; 103(24): 2876 - 2878. [Full Text] [PDF]
|
|
|
|
|
|
I. Iglesias-Garriz, F.e. Corral, M. A. Rodriguez, C. Garrote, M. Montes, and E. Sevillano Pre-infarction angina elicits greater myocardial viability on reperfusion after myocardial infarction: a dobutamine stress echocardiographic study J. Am. Coll. Cardiol., June 1, 2001; 37(7): 1846 - 1850. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. M. Yellon and A. Dana The Preconditioning Phenomenon : A Tool for the Scientist or a Clinical Reality? Circ. Res., September 29, 2000; 87(7): 543 - 550. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Miki, T. Miura, A. Tsuchida, A. Nakano, T. Hasegawa, T. Fukuma, and K. Shimamoto Cardioprotective Mechanism of Ischemic Preconditioning Is Impaired by Postinfarct Ventricular Remodeling Through Angiotensin II Type 1 Receptor Activation Circulation, July 25, 2000; 102(4): 458 - 463. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. E. Johnston Preconditioning the Brain and Heart: Implications for Cardiac Surgery Seminars in Cardiothoracic and Vascular Anesthesia, July 1, 2000; 4(2): 70 - 79. [Abstract] [PDF]
|
|
|
|
|
|
C. Whan Lee, S.-W. Park, G.-Y. Cho, M.-K. Hong, J.-J. Kim, D.-H. Kang, J.-K. Song, H.-J. Lee, and S.-J. Park Pressure-derived fractional collateral blood flow: a primary determinant of left ventricular recovery after reperfused acute myocardial infarction J. Am. Coll. Cardiol., March 15, 2000; 35(4): 949 - 955. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Noda, S. Minatoguchi, K. Fujii, M. Hori, T. Ito, K. Kanmatsuse, M. Matsuzaki, T. Miura, H. Nonogi, M. Tada, et al. Evidence for the delayed effect in human ischemic preconditioning: Prospective multicenter study for preconditioning in acute myocardial infarction J. Am. Coll. Cardiol., December 1, 1999; 34(7): 1966 - 1974. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Liuzzo, L. M. Biasucci, J. R. Gallimore, G. Caligiuri, A. Buffon, A. G. Rebuzzi, M. B. Pepys, and A. Maseri Enhanced inflammatory response in patients with preinfarction unstable angina J. Am. Coll. Cardiol., November 15, 1999; 34(6): 1696 - 1703. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H.-S. V. Chen, S. C. Body, and S. K. Shernan Myocardial Preconditioning: Characteristics, Mechanisms, and Clinical Applications Seminars in Cardiothoracic and Vascular Anesthesia, July 1, 1999; 3(2): 85 - 97. [Abstract] [PDF]
|
|