Document Detail

Ambulatory blood pressure monitoring early after acute myocardial infarction: development of a new prognostic index.
MedLine Citation:
PMID:  17353648     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: The aim of our study was to assess the possible role of a prognostic index based on ambulatory blood pressure monitoring in a large cohort of patients with recent myocardial infarction. METHODS: The study population included 1335 consecutive patients admitted for ST elevation myocardial infarction and discharged alive from 48 Italian hospitals participating in the multicentric IMPRESSIVE (Infarto Miocardico, Pressione arteriosa e frequenza cardiaca. Studio Italiano di Valutazione Epidemiologica) study. Ambulatory blood pressure monitoring was performed 3 weeks after discharge, with a clinical follow-up of 12 months. End-points included cardiac death and new admission for heart failure. A prognostic index was obtained from the ambulatory blood pressure monitoring variables according to the formula: (220-age)-mean 24 h heart rate (m24hHR)+mean 24 h diastolic blood pressure (m24hDBP). RESULTS: Among many potential predictors only left-ventricular ejection fraction, creatinine levels, Killip class and the prognostic index were independently associated with events during the follow-up. In particular, higher values of the prognostic index were associated with a lower incidence of events, with an odds ratio of 0.958 (95% confidence intervals 0.943-0.974) and a 4% reduction in risk for each point of the prognostic index. Overall incidence of cardiac events was 6-fold higher in patients within the lowest quartile of the prognostic index (< or =148) compared with the other three quartiles (12 vs. 2, 1.4 and 2% respectively in the other three quartiles; P<0.0001). CONCLUSIONS: A simple prognostic index based on ambulatory blood pressure monitoring and age may be a useful tool in predicting cardiac death and heart failure in patients with recent myocardial infarction.
Lanfranco Antonini; Vincenzo Pasceri; Salvatore Greco; Furio Colivicchi; Solferina Malfatti; Sergio Pede; Vincenzo Guido; Amir Kol; Massimo Santini
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Blood pressure monitoring     Volume:  12     ISSN:  1359-5237     ISO Abbreviation:  Blood Press Monit     Publication Date:  2007 Apr 
Date Detail:
Created Date:  2007-03-13     Completed Date:  2007-06-06     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9606438     Medline TA:  Blood Press Monit     Country:  England    
Other Details:
Languages:  eng     Pagination:  69-74     Citation Subset:  IM    
Cardiovascular Department, San Filippo Neri Hospital, Via Anneo Lucano 26, 00136 Rome, Italy.
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MeSH Terms
Blood Pressure Monitoring, Ambulatory*
Cohort Studies
Death, Sudden, Cardiac / epidemiology
Follow-Up Studies
Heart Failure / diagnosis,  epidemiology
Middle Aged
Myocardial Infarction / diagnosis*,  epidemiology*
Predictive Value of Tests
Risk Factors
Stroke Volume

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