Effect of Antecedent Hypertension on Mortality after Acute Coronary Syndromes in Coronary Intervention Era: A Meta-analysis

Abstract

Background Effect of antecedent hypertension on mortality after acute coronary syndromes (ACS) in the percutaneous coronary intervention (PCI) era is less clear. The aim of this meta-analysis was to assess effect of antecedent hypertension on short and long-term mortality after ACS in the coronary intervention era.Methods PubMed, Medline, EMBASE and the Cochrane library were systematically searched up to April 2023. Ten studies with total of 64, 989 of patients met the inclusion criteria. The outcomes of interest were (i) all-cause in-hospital mortality; (ii) long-term all- cause mortality.Results No significant difference was observed in in-hospital mortality between antecedent hypertension group and non-antecedent hypertension with pooled odds ratio (OR): 1.07, 95% confidence interval (CI): 0.79–1.45; I2 = 82%, the same as ST elevation myocardial infarction (STEMI) group (pooled OR: 1.01, 95% CI: 0.73– 1.39; I2 = 66%). However, result was statistically significant for non-ST elevation myocardial infarction (NSTE-ACS) patients, with pooled OR: 0.67, 95% CI: 0.55–0.82; p = 0.0001, I2 = 0%. Antecedent hypertension was related to increased long-term mortality of patients with ACS (pooled OR 1.28, 95% CI 1.16–1.40, p = 0.0001; I2 = 0%), the same as STEMI subgroups.Conclusion In PCI era antecedent hypertension was associated with higher long-term mortality in ACS patients, but no significant difference was observed in in-hospital mortality between hypertension and non- hypertension. However, for NSTE-ACS patients’ antecedent hypertension may be a protective factor related to in- hospital mortality.