Abstract 17080: Low Peripheral Pulse Pressure During Primary Percutaneous Coronary Intervention in ST-Segment Elevation Myocardial Infarction Patients is a Predictor of Persistent Systolic Dysfunction
Background: Peripheral pulse pressure ( PPP) is routinely measured during primary percutaneous coronary intervention (PCI). However, little is known about the correlation between PPP and systolic function. We sought to determine the prognostic value of PPP for predicting long-term systolic function in patients with ST- Segment Elevation Myocardial Infarction (STEMI).
Methods: Patients with acute STEMI without previous history of heart failure (N=241) who underwent primary PCI were studied retrospectively. PPP was measured at the time of primary PCI using standard sphygmomanometer. Patients were divided into tertiles according to PPP. Patients in the lowest tertile (Group A, PP<49 mmHg, n=88) were compared with the remainder of the cohort (Group B, n=153). Systolic function was assessed using 2D transthoracic echocardiogram within a week of primary PCI (n=234) and at follow up (n=132). Systolic dysfunction was defined as ejection fraction (EF) < 40%.
Results: In our study population, (mean age 57 ±12 years, male 66%) there was a high prevalence of smoking (70%), Hyperlipidemia (76 %), Hypertension (77%) and, Diabetes (34%). Mean EF for the entire cohort at admission was 49±13%. Patient in Group A had significantly lower mean EF compared with group B at admission (45% vs. 51%) and follow up (48% vs. 53%) ( p<0.05 for both). On follow up at a median of 148 days (IQR 73-486 days), 24 of 132 patients had persistent systolic dysfunction. Group A were significantly more likely to have persistent systolic dysfunction with adjusted (Age, sex, BMI, HTN, HLD, DM, smoking, CKD, medications) OR of 4.06 (1.2-12.8) respectively (p=0.017).
Conclusion: Low PPP at the time of primary PCI is associated with increased risk of persistent systolic dysfunction in patients with STEMI.
Author Disclosures: M. Madmani: None. T. Pasala: None. D. Sharma: None. S. Gandhi: None.
- © 2014 by American Heart Association, Inc.