013 Pre-infarction angina and cardiovascular complications in non ST segment elevation myocardial infarction: Data from the RICO survey

BackgroundThe presence of preinfarction angina (PIA) has been shown to confer cardioprotection after ST segment elevation myocardial infarction (MI). However, the impact of PIA in non ST segment elevation (NSTEMI) remains to be determined.Patients and MethodsFrom the obseRvatoire des Infarctus de Côte d’Or (RICO) survey, 1541 consecutive patients admitted in intensive care unit with a first NSTEMI were included in the study. Patients who experienced chest pain <7 days before the episode leading to admission were defined as having PIA. Patients presenting with PIA were compared with patients without PIA. Prehospital resuscitated cardiac arrest (RCA), incidence of in-hospital ventricular arrhythmias (VA), heart failure (Killip class>1) and 30-day mortality were collected.ResultsAmong the 1541 patients included in the study, 693 patients presented PIA. Baseline clinical characteristics were similar for the 2 groups. There was no significant difference for the GRACE risk score (p=0.942). However, PIA was associated with a lower creatine kinase peak, as a reflect of infarct size (231(109-520) vs. 322(148-844) IU/L, p<0.001) and a lower rate of patients with a troponin peak >100 ULN (31% vs. 39%, p<0.001) when compared with the group without PIA. Patients with PIA were admitted with markedly less pre-hospital RCA (0.6% vs. 3.4%, p