Abstract 17786: Impact of High Admission Blood Pressure Without History of Hypertension on Clinical Outcomes of Patients With Acute Myocardial Infarction
OBJECTIVES: We aimed to investigate how admission BP status impact on clinical outcomes after percutaneous coronary intervention (PCI) in Korean acute myocardial infarction (AMI) patients.
BACKGROUND: Hypertension (HTN) has been considered a strong risk factor of acute myocardial infarction (AMI). However, growing evidence suggests that low blood pressure (BP) plays a role against adequate myocardial perfusion in AMI.
METHODS: Between November 2005 and July 2011, 36,069 consecutive AMI patients were enrolled in Korea Acute Myocardial Infarction Registry. They were divided into four groups according to admission BP status [Group I (n=2,568): patients with normal BP and without HTN history, Group II (n=916): patients with normal BP and with HTN history, Group III (n=16,383): patients with high BP and with HTN history, Group IV (n=16,202): patients with high BP and without HTN history]. Primary endpoint was composite of major adverse cardiac events (MACE) at one year.
RESULTS: Kaplan-Meier analysis showed lowest incidence of MACE in Group IV (p<0.0001 by log-rank test). Group III also showed better results than Group I or II (p<0.0001). However, Group I and II showed similar results, which showed highest incidence of MACE. Moreover, survival analysis using Cox proportional hazard model revealed that patients in Group IV turned out to be one of the independent factors for prediction of MACE-free survival (HR 0.867, 95% CI 0.773-0.972, p=0.015) even after adjusting multiple variables. MACE according to DBP group after PCI with second generation DES revealed less J-curve relationship.
CONCLUSIONS: Non-hypertensive AMI patients presenting with high admission BP showed most favorable clinical outcomes among groups at one year after PCI. This category of patients remained to be one of the independent predictors for lowering major adverse cardiac events.
- © 2013 by American Heart Association, Inc.