Effects of preinfarction angina on diabetic patients with acute myocardial infarction

Objective To evaluate the effects of preinfarction angina on diabetic patients with acute myocardial infarction(AMI)and its mechanism.Method 216 diabetic patients with AMI were divided into two groups:no previous angina(group A,n=78);preinfarction anginao ccurring within 48h before onset of AMI(group B,n=138).All patients underwent thrombolysis or direct PCI within 6h after onset of AMI;Plasma necrosis inflammation markers were continuously meastlred;99mTc gated cardiac blood pool image was performed to measure ventricular function at 2 weeks.The incidence of arrythmia,heart failure,cardiogenic shock,and mortality in hospital stay wa8 observed.Results ①The peak of creatine MB fraction(CK-MB),brain natriuretic peptide,cardiac troDoRin Ⅰ,and intedeukin-8 was signilicantly lower in group B than that of group A(P＜0.05).②Left ventricular systolic perfornlance parameters including LVEF,LPER and LTPER were better in group B than those in group A(P＜0.05);Left ventficular diastolic performance parameters including LPFR and LTPFR were also better in group B than that in group A(P＜0.05).③The incidence of arrythmia,heart failure or cardiogenic shock,and mortality was lower in group B than that in group A(P＜0.05).Conclusion Preinfaretion angina has cardioprotective effects in diabetic patients,including limiting infarct area,protecting ventricular function and improving prognosis,the mechnism of which could be that preinfarction angina inhabits overactivating of nerve endocrine hormone and cytokine. Key words: Angina pectoris;  Acute myocardial infarction;  Diabetes;  Cardiac function