Chest pain prior to a heart attack can protect the heart

(Press-News.org) MINNEAPOLIS, MN – Feb. 5, 2013 – Patients who experience chest pain in the 24 hours preceding a heart attack, also called preinfarction angina, have smaller heart attacks and improved cardiac function in the contemporary cardiac stenting era, researchers found in a study published Jan. 22 in Circulation: Cardiovascular Interventions.

"Even before we began treating heart attack patients with angioplasty and stenting, physicians recognized that patients with chest pain prior to their heart attack seem to have better outcomes," says the study's senior author, Jay H. Traverse, MD, a research cardiologist at the Minneapolis Heart Institute Foundation in Minneapolis. "The question 'Given faster treatment times for stents, would the protective benefit be maintained?' still remained."

Prior to this study, there have only been a few, small studies to assess this effect in the cardiac stenting era. The researchers retrospectively assessed 1,031 patients admitted with a first acute heart attack, or ST-elevation myocardial infarction (STEMI). They then analyzed all patients who had ongoing chest pain duration between one and six hours who received a cardiac stent to treat their heart attack, with a procedure called primary percutaneous coronary intervention.

They identified 245 patients at the Minneapolis Heart Institute® at Abbott Northwestern Hospital who had occluded arteries on presentation, of which 79 patients had documented preinfarction angina, defined as episodes of similar chest pain within 24 hours of the onset of their heart attack. "Physicians may not realize that between 30 and 40 percent of all STEMI patients experience preinfarction angina," Traverse says.

In the study, the researchers found that the occurrence of preinfarction resulted in a 50 percent reduction in heart attack size compared with patients without preinfarction angina. This translated into improved cardiac function at the time of the patient's discharge.

"Preinfarction angina appears to be a trigger that activates endogenous protective mechanisms in the heart," he concludes. "Future research should be focused upon identifying what these protective mechanisms are, as there may be a method of pharmacologically activating them."

### About the Minneapolis Heart Institute Foundation The Minneapolis Heart Institute Foundation is dedicated to creating a world without heart disease through groundbreaking clinical research and innovative education programs. MHIF's mission is to promote and improve cardiovascular health, quality of life and longevity for all. Scientific Innovation and Research – Publishing more than 120 peer-reviewed studies each year, MHIF is a recognized research leader in the broadest range of cardiovascular medicine. Each year, cardiologists and hospitals around the world adopt MHIF protocols to save lives and improve patient care.

Education and Outreach – Research shows that modifying specific health behaviors can significantly reduce the risk of developing heart disease. Through community programs, screenings and presentations, MHIF educates people of all walks of life about heart health. The goal of the Foundation's community outreach is to increase personal awareness of risk factors and provide the tools necessary to help people pursue heart- healthy lifestyles.

About the Minneapolis Heart Institute® The Minneapolis Heart Institute® is recognized internationally as one of the world's leading providers of heart and vascular care. This state-of-the-art facility combines the finest in personalized patient care with sophisticated technology in a unique, family-oriented environment. The Institute's programs, a number of which are conducted in conjunction with Abbott Northwestern Hospital, address the full range of heart and vascular health needs: prevention, diagnosis, treatment and rehabilitation.