Abstract 15376: Systolic Blood Pressure Variability in Patients With ST-Elevation Myocardial Infarction Predicts the Long-Term Cardiovascular Outcomes
Introduction: Elevated visit-to-visit blood pressure variability (BPV), independent of mean BP, has been associated with cardiovascular events in some diseases. The impact of visit-to-visit BPV after ST-elevation myocardial infarction (STEMI), however, has not been established.
Hypothesis: This study aimed to investigate the prognostic impact of BPV on the patients after STEMI.
Methods: We analyzed the data and clinical outcomes of the survivors after STEMI who underwent successful primary coronary intervention. In the estimate of BPV, BP measurements at discharge and at 1, 3, 6, 12, 24 and 36months were taken into account. The intraindividual standard deviation (SD) of systolic BP (SBP) across these measurements was calculated as index of BPV. Patients were classified into a high-BPV group and low-BPV group (the high-BPV group, SD ≥ median SD and the low-BPV group, SD < median SD). Occurrence of major adverse cardiovascular events (MACE; death, recurrent MI, target vessel revascularization (TVR)) within 60 months was evaluated.
Results: We enrolled 343 patients(58 ± 12 year-old) and mean follow-up duration was 68 ± 34 months. The intraindividual mean and median SD of SBP were 13.2 ± 7.6 and 12.3 mmHg. The MACE-free survival of the high-BPV group was significantly worse than the low-BPV group (log-rank p = 0.035, figure). For the high-BPV group, the relative risk of a MACE significantly increased by 57% (95% CI, 1.03-2.39, p = 0.038, Table).
Conclusions: The visit-to-visit systolic BPV was associated with increased rate of adverse clinical outcomes in the patients after STEMI. Careful assessment of BP and trial to reduce BPV might be also important in the survivors after STEMI.
Author Disclosures: M. Soh: None. J. Park: None. K. Seo: None. H. Yang: None. H. Lim: None. B. Choi: None. S. Choi: None. M. Yoon: None. G. Hwang: None. S. Tahk: None. J. Shin: None.
- © 2016 by American Heart Association, Inc.