Document Detail


The clinical course of acute ST-elevation myocardial infarction in patients with hypertension.
MedLine Citation:
PMID:  20301024     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Arterial hypertension has been documented as one the cardiovascular risk factors. The issue whether hypertension worsens the clinical course and short-term prognosis of patients with acute ST-elevation myocardial infarction (STEMI) has been addressed by several studies, however, the results were not uniform. AIM: To compare the clinical course and short-term prognosis in STEMI patients with or without hypertension. METHODS: The study group consisted of 366 patients with STEMI, of whom 234 (63.9%) had a history of hypertension (150 males, mean age 58.5+/-11.2 years) whereas 132 (100 males, mean age 60.3+/-11.9) did not. All patients underwent primary angioplasty with stent implantation. Details from medical history, cardiovascular risk factors, clinical course and in-hospital complications were recorded and compared between patients with and without hypertension. RESULTS: There were differences between both study groups in the prevalence of cardiovascular risk factors. Patients with hypertension had more frequently history of coronary artery disease (56 vs. 37%, p<0.01), BMI>25 kg/m2 (90 vs. 85%, p<0.01), type 2 diabetes (27 vs. 14%, p<0.05), hyperlipidaemia (56 vs. 43%, p<0.05), and renal disease (11 vs. 5%, p<0.05). Clinical course of MI was more complicated in patients with hypertension who had more often cardiogenic shock (10 vs. 6%, p<0.05), pulmonary oedema (12 vs. 4%, p<0.05), sinus tachycardia>90 beats/min on admission (12 vs. 4%, p<0.05), ventricular tachycardia or fibrillation (20 vs. 11%, p<0.01) and complete atrioventricular block (11 vs. 4%, p<0.01). In-hospital deaths occurred in 18 (7.7%) patients with hypertension and 7 (5.3%) patients without hypertension (NS). Multivariate analysis identified age>65 years, symptoms of heart failure, atrial fibrillation, elevated blood glucose level and creatinine level as independent prognostic factors of adverse outcome in both groups whereas history of stroke, increased while cell blood count, urea level and two-vessel disease where independent prognostic variables in patients with hypertension. Ventricular tachycardia or fibrillation had prognostic significance only in STEMI patients without hypertension. CONCLUSION: Patients with STEMI and hypertension have more cardiovascular risk factors and more complicated in-hospital course of MI than normotensive patients.
Authors:
Magdalena Rembek; Aleksander Goch; Jan Goch
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Kardiologia polska     Volume:  68     ISSN:  0022-9032     ISO Abbreviation:  Kardiol Pol     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-03-19     Completed Date:  2010-07-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376352     Medline TA:  Kardiol Pol     Country:  Poland    
Other Details:
Languages:  eng     Pagination:  157-63     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Medical University, Lodz, Poland.
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MeSH Terms
Descriptor/Qualifier:
Atrial Fibrillation / epidemiology
Causality
Comorbidity
Coronary Disease / epidemiology
Diabetes Mellitus, Type 2 / epidemiology
Disease Progression
Female
Humans
Hyperlipidemias / epidemiology
Hypertension / epidemiology*
Kidney Diseases / epidemiology
Male
Middle Aged
Myocardial Infarction / epidemiology*,  therapy
Prognosis
Pulmonary Edema / epidemiology
Risk Factors
Shock, Cardiogenic / epidemiology
Tachycardia, Ventricular / epidemiology
Comments/Corrections
Comment In:
Kardiol Pol. 2010 Feb;68(2):164-5   [PMID:  20476492 ]

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