The Impact of Angina Pectoris Prior to Right Ventricular Myocardial Infarction on the Development of Cardiovascular Outcomes at Long-Term Follow-Up

Background: Previous chronic angina pectoris (AP) to acute myocardial infarction (MI) is associated with multivessel disease and poor prognosis. The impact of the AP on the risk of adverse cardiovascular events (ACVE) after posterior STEMI involving right ventricle (RV) is not insufficiently studied.
Purpose: To estimate the impact of the chronic AP before MI on the development of ACVE at 30-month follow-up in patients with RV MI.
Methods: 155 patients with RV MI aged 64.11± 0.78 years were evaluated. The 1^st group - 97 (62.6%) patients had chronic AP before MI, and the 2^nd group - 58 (37.4%) patients – without AP in anamnesis. Follow-up was 30±4.5 months. Endpoints were: unstable angina (UA), recurrent MI (Re-MI), stroke, cardiovascular (CV) death and HF-hospitalizations.
Results: Patients with AP differed of older age (p=0.005), a greater frequency of diabetes mellitus (p=0.017) and hypertension (p=0.0013). Study endpoints occurred in 65 (41.9%) patients: UA - 50 (32.2%), Re-MI - 15 (9.6%), stroke - 9 (5.8%), CV-death - 16 (10.3%), HF-hospitalization – 22 (14.2%). The frequency of HF-hospitalization (χ² =6.193; р=0.013), UA (Χ² =17.29; р=0.0001), Re-MI (Χ² =6.707; p=0.025) and CV-death (Χ² =7.402; р=0.0065) were significantly higher in the 1^st group. After 30-month follow-up the ACVE occurred in 51 (52.6%) patients with previous AP when compared with 14 (24.1%) patients in the 2^nd group, (Cox`s F-Test: p = 0.00001).
Conclusion: The chronic AP previous RV MI is associated with significant increase of the risk ACVE, in particular, CV-death, Re-MI, UA and HF-hospitalizations during 30-month follow-up.