Prognosis importance of absence of angina in non-ST elevation myocardial infarction

Abstract

Purpose: Cardiac troponins increased myocardial infarction diagnosis in patients without specific electrocardiographic changes. Absence of angina has become common and prognostic significance remains unclear. Methods: We followed 204 consecutive patients after myocardial infarction non-ST elevation(NSTEMI) at emergency department. Outcomes were in-hospital death and follow-up death or cardiac readmission. Results: No-angina (NAG) group (n = 27, 13.2%) had more women (p = 0.001), higher blood glucose (p =0.011) and B-type natriuretic factor (p < 0.001). In-hospital (14.8% vs 4.5%,p = 0.035) and 20-months follow-up mortality (43.5% vs 12.9%, p<0.001) were higher in NAG. Combination of death and cardiac read- mission was similar (70.4%vs 53.1%, p = 0.093). Age (HR = 1.038, 95% CI 1.006 to 1.071), absence of angina at admission (HR 2.554, 95% CI 1.037 to 6.289), male gender (HR 2.706, 95% CI 1.099 to 6.667) and dyspnea (HR 3.113, 95% CI 1.417 to 6.842) were independent predictors of long-term mortality. Conclusion: The absence of chest pain in NSTEMI implies in higher in-hospitaland long-term mortality.