{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T19:14:28Z","timestamp":1754162068126,"version":"3.41.2"},"reference-count":35,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Pre-infarction angina (PIA) is associated with improved prognosis in patients with ST-elevation myocardial infarction (STEMI). Some studies suggest that diabetes may blunt the effect of ischaemic preconditioning. We sought to study the impact of PIA in diabetic patients with STEMI.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>Consecutive patients with STEMI who underwent primary angioplasty were included. PIA was defined as \u22651 episode of chest pain during the week preceding STEMI diagnosis. Incident major adverse cardiovascular events (MACE) were defined as the first occurrence of all-cause death, stroke or acute myocardial infarction.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Of the 1143 included patients, 25% were diabetic and 32% had a history of PIA. Diabetic patients with PIA had smaller infarct sizes as estimated by peak creatine kinase (CK) [1144 (500\u20132212) vs. 1715 (908\u20133309) U\/L, <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.003] and peak troponin [3.30 (1.90\u20136.58) vs. 4.88 (2.50\u20139.58) ng\/ml, <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.002], compared to diabetics without PIA. They also had a lower likelihood of evolving with moderate to severe reduced left ventricle ejection fraction (LVEF) (25.6%, <jats:italic toggle=\"yes\">n<\/jats:italic> = 22 vs. 46.6%, <jats:italic toggle=\"yes\">n<\/jats:italic> = 82, <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.001). In non-diabetic patients, PIA was associated with reduced peak CK [1549 (909\u20132909) vs. 1793 (996\u20133078), <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.0497], but not troponin (3.74 [2.23\u20137.11] vs. 4.56 [2.44\u20137.77] ng\/ml, <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.19), and was not associated with reduced LVEF (32.0%, <jats:italic toggle=\"yes\">n<\/jats:italic> = 85 vs. 37.4%, <jats:italic toggle=\"yes\">n<\/jats:italic> = 207, <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.13). Both diabetic and non-diabetic patients with PIA had a lower likelihood of evolving with a Killip class III\/VI (non-diabetic patients: 5.6% vs. 14.1%, <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.002; diabetic patients: 12.8% vs. 24.6%, <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.049). Over a median follow-up of 18.0 (12.1\u201325.5) months, PIA was associated with a significant reduction in the incidence of MACE [hazard ratio 0.52, 95% confidence interval (CI) 0.37\u20130.74, <jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.001], irrespective of diabetes status.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>PIA is an independent predictor of favourable outcomes in the setting of STEMI for both diabetic and non-diabetic patients.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/mca.0000000000000968","type":"journal-article","created":{"date-parts":[[2020,10,15]],"date-time":"2020-10-15T11:33:30Z","timestamp":1602761610000},"page":"375-381","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Pre-infarction angina is associated with improved prognosis in diabetic patients with ST-elevation myocardial infarction \u2013 data from a contemporary cohort"],"prefix":"10.1097","volume":"32","author":[{"given":"Marta","family":"Fontes Oliveira","sequence":"first","affiliation":[{"name":"Cardiology Department, University Hospital Centre of Porto"}]},{"given":"Ricardo","family":"Costa","sequence":"additional","affiliation":[{"name":"Cardiology Department, University Hospital Centre of Porto"}]},{"given":"Andr\u00e9","family":"Frias","sequence":"additional","affiliation":[{"name":"Cardiology Department, University Hospital Centre of Porto"}]},{"given":"Raquel","family":"Santos","sequence":"additional","affiliation":[{"name":"Cardiology Department, University Hospital Centre of Porto"}]},{"given":"Bruno","family":"Brochado","sequence":"additional","affiliation":[{"name":"Cardiology Department, University Hospital Centre of Porto"}]},{"given":"M\u00e1rio","family":"Santos","sequence":"additional","affiliation":[{"name":"Cardiology Department, University Hospital Centre of Porto"},{"name":"Pulmonary Vascular Disease Unit, University Hospital Centre of Porto"},{"name":"Endocrine, Cardiovascular & Metabolic Research, Unit for Multidisciplinary Research in Biomedicine (UMIB), University of Porto, Porto, Portugal"}]},{"given":"Jo\u00e3o","family":"Silveira","sequence":"additional","affiliation":[{"name":"Cardiology Department, University Hospital Centre of Porto"}]},{"given":"Sofia","family":"Cabral","sequence":"additional","affiliation":[{"name":"Cardiology Department, University Hospital Centre of Porto"}]},{"given":"Andr\u00e9","family":"Luz","sequence":"additional","affiliation":[{"name":"Cardiology Department, University Hospital Centre of Porto"},{"name":"Endocrine, Cardiovascular & Metabolic Research, Unit for Multidisciplinary Research in Biomedicine (UMIB), University of Porto, Porto, Portugal"}]},{"given":"Severo","family":"Torres","sequence":"additional","affiliation":[{"name":"Cardiology Department, University Hospital Centre of Porto"}]}],"member":"276","published-online":{"date-parts":[[2020,10,13]]},"reference":[{"key":"R1-20250729","doi-asserted-by":"crossref","first-page":"e139","DOI":"10.1161\/CIR.0000000000000757","article-title":"Heart disease and stroke statistics\u20142020 update.","volume":"141","author":"Virani","year":"2020","journal-title":"Circulation"},{"key":"R2-20250729","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1016\/0735-1097(95)80002-X","article-title":"Preinfarction angina as a major predictor of left ventricular function and long-term prognosis after a first Q wave myocardial infarction.","volume":"26","author":"Anzai","year":"1995","journal-title":"J Am Coll Cardiol"},{"key":"R3-20250729","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/S0002-9149(00)01262-5","article-title":"Effect of preinfarction angina pectoris on outcome in patients with acute myocardial infarction treated with primary angioplasty (results from the Myocardial Infarction Registry.","volume":"87","author":"Zahn","year":"2001","journal-title":"Am J Cardiol"},{"key":"R4-20250729","doi-asserted-by":"crossref","first-page":"1545","DOI":"10.1016\/j.jacc.2005.02.033","article-title":"Prodromal angina limits infarct size in the setting of acute anterior myocardial infarction treated with primary percutaneous intervention.","volume":"45","author":"Ottani","year":"2005","journal-title":"J Am Coll Cardiol"},{"key":"R5-20250729","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1161\/01.CIR.91.1.37","article-title":"Previous angina alters in-hospital outcome in TIMI 4. 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