Sotomi Yohei, Ueda Yasunori, Hikoso Shungo, Okada Katsuki, Dohi Tomoharu, Kida Hirota, Oeun Bolrathanak, Sunaga Akihiro, Sato Taiki, Kitamura Tetsuhisa, Mizuno Hiroya, Nakatani Daisaku, Sakata Yasuhiko, Sato Hiroshi, Hori Masatsugu, Komuro Issei, Sakata Yasushi
Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Osaka, Japan.
Cardiovascular Division, National Hospital Organization Osaka National Hospital, Osaka, Japan.
Front Cardiovasc Med. 2022 May 26;9:867723. doi: 10.3389/fcvm.2022.867723. eCollection 2022.
As part of efforts to identify candidates for patient education aimed at decreasing mortality from acute myocardial infarction, we investigated the prevalence of pre-infarction angina and its predictors among comorbidities in patients who were hospitalized with acute myocardial infarction (MI).
We conducted a prospective multicenter observational registry of MI patients from 1998 to 2014 ( = 12,093). The present study investigated the prevalence of pre-infarction angina and its predictors among comorbidities with a logistic regression model. Pre-infarction angina was defined as chest pain/oppression observed within 1 month before the onset of MI but which lasted <30 min.
After excluding 976 (8.1%) patients with missing data on pre-infarction angina, 11,117 patients [66.4 ± 12.0 years, 9,096 (75.2%) male] were analyzed. Of these, 5,428 patients (48.8%) experienced pre-infarction angina before the onset of MI, while 5,689 (51.2%) experienced sudden onset of acute MI. Most patients experienced the first episode of angina >6 h before the onset of MI, while 15% did so ≤6 h before. Patients with hypertension, diabetes, dyslipidemia, or a family history of MI had a higher probability of pre-infarction angina than those without. Elderly patients and those with a history of cerebrovascular disease were less likely to experience pre-infarction angina.
Almost half of MI patients in our registry experienced pre-infarction angina before MI onset. Patients with hypertension, diabetes, dyslipidemia, or a family history of MI had a higher probability of experiencing pre-infarction angina than those without.
作为旨在确定可通过患者教育降低急性心肌梗死死亡率的候选对象的工作的一部分，我们调查了急性心肌梗死（MI）住院患者中梗死前心绞痛的患病率及其在合并症中的预测因素。
我们对1998年至2014年的MI患者进行了一项前瞻性多中心观察登记研究（n = 12,093）。本研究采用逻辑回归模型调查梗死前心绞痛的患病率及其在合并症中的预测因素。梗死前心绞痛定义为在MI发病前1个月内观察到的胸痛/胸闷，但持续时间<30分钟。
在排除976例（8.1%）梗死前心绞痛数据缺失的患者后，对11,117例患者[66.4±12.0岁，9,096例（75.2%）男性]进行了分析。其中，5,428例患者（48.8%）在MI发病前经历过梗死前心绞痛，而5,689例（51.2%）经历了急性MI的突然发作。大多数患者在MI发病前>6小时经历了首次心绞痛发作，而15%的患者在发病前≤6小时经历了首次心绞痛发作。患有高血压、糖尿病、血脂异常或有MI家族史的患者发生梗死前心绞痛的可能性高于无这些情况的患者。老年患者和有脑血管疾病史的患者发生梗死前心绞痛的可能性较小。
在我们的登记研究中，几乎一半的MI患者在MI发病前经历过梗死前心绞痛。患有高血压、糖尿病、血脂异常或有MI家族史的患者比无这些情况的患者发生梗死前心绞痛的可能性更高。
