Document Detail


Prognostic Significance of Presenting Blood Pressure in Patients With ST-Elevation Myocardial Infarction Undergoing Percutaneous Coronary Intervention.
MedLine Citation:
PMID:  25430698     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: We evaluated the impact of normal vs. high presenting blood pressure (BP) on clinical outcomes and cardiac function in patients with ST-elevation myocardial infarction (MI).
METHODS: In 11,292 patients, in-hospital mortality and major adverse clinical events (MACE; all-cause death, nonfatal MI, or any revascularization) during follow-up were compared between patients with normal (≥100mm Hg and ≤139mm Hg) and high (≥140mm Hg) systolic BP at presentation.
RESULTS: Compared to patients with high BP, patients with normal BP had significantly higher in-hospital mortality (1.5% vs. 3.7%; P < 0.001), especially in those with prior hypertension, and higher rates of all-cause death (3.3% vs. 5.3%; P < 0.001) and MACE (9.8% vs. 11.8%; P = 0.04) during follow-up (median: 330 days). After multivariate adjustment, normal BP was associated with higher risk of in-hospital mortality (adjusted hazard ratio (HR) = 2.268; 95% confidence interval (CI) = 1.144-4.498; P = 0.019), but not all-cause death (adjusted HR = 0.956; 95% CI = 0.602-1.517) or MACE (adjusted HR = 0.935; 95% CI = 0.755-1.158). Left ventricular ejection fraction at baseline and follow-up was significantly lower in patients with normal BP (52% vs. 51%; P < 0.001 and 55% vs. 54%; P = 0.018, respectively).
CONCLUSIONS: Our findings indicate that patients with normal presenting BP, especially those with prior hypertension, exhibit higher in-hospital mortality and poorer cardiac function compared to patients with high BP. Although outcomes during follow-up did not differ, cardiac function was persistently poorer in patients who presented with normal BP.
Authors:
Jin Sup Park; Kwang Soo Cha; Donghun Shin; Dae Sung Lee; Hye Won Lee; Jun-Hyok Oh; Jung Hyun Choi; Han Cheol Lee; Taek Jong Hong; Sang Hyun Lee; Jeong Su Kim; Yong Hyun Park; June Hong Kim; Kook-Jin Chun; Myung Ho Jeong; Youngkeun Ahn; Shung Chull Chae; Young Jo Kim;
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-11-27
Journal Detail:
Title:  American journal of hypertension     Volume:  -     ISSN:  1941-7225     ISO Abbreviation:  Am. J. Hypertens.     Publication Date:  2014 Nov 
Date Detail:
Created Date:  2014-11-28     Completed Date:  -     Revised Date:  2014-11-29    
Medline Journal Info:
Nlm Unique ID:  8803676     Medline TA:  Am J Hypertens     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© American Journal of Hypertension, Ltd 2014. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
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