Relation between the timing of the last preinfarction angina and microvascular reperfusion in patients with recanalized acute myocardial infarction

In patients with recanalized acute myocardial infarction (AMI). the relation between the timing of preinfarction angina (PA) and microvascular reperfusion remains nuclear. A total of 186 patients (114 with anterior and 72 with inferior AMI) who had total occlusion and TIMI 3 recanalization less than or equal to6 hours(.)from the onset of AMI were divided into A groups according to the time interval between the last episode of PA and the onset of AML 5 2 hours (group A n = 52); 2 to 48 hours (group 13, n = 43) greater than or equal to 48 hours (group C. n = 33). and no PA (group D, n = 58). The angiographic myocardial blush grade. a mark-er of microvascular reperfusion, was retrospectively assessed immediately( after recanalization. There were no differences in baseline characteristics except for sex among the 4 groups. Myocardial blush grade 3 was more frequent (42% vs 21%, 9%. and 14%) and peak-creatine kinase was lower (2659 vs 3455, 4422, and 4622 mU/mL) in group A that] in groups 13, C, and D (all P < 0.05). multivariate analysis showed that PA occurring ! 2 hours before AMI (OR 3.88 P < 0.05), a smaller summed ST-segment elevation before recanalization (OR 0.84 P < 0.01), earlier time to recanalization (OR 0.522 P < 0.05). and inferior AMI (OR 4.87 P < 0.05) were independently associated with adequate microvascular reperfusion. We conclude that PA less than or equal to 2 hours before the onset of AMI is independently associated with adequate microvascular reperfusion after recanalization in patients with AMI.