Effect of Elevated Pulmonary Artery Systolic Pressure on Short-Term Prognosis in Patients With Acute Myocardial Infarction

Abstract

Pulmonary artery systolic pressure (PASP) may increase because of cardiac alterations that result in increased filling pressures after acute myocardial infarction (AMI). We hypothesized that PASP might be a useful maker to predict the risk of cardiac death after AMI. We carried out a retrospective study from 2013 to 2017 involving 5401 patients with AMI. Patients were grouped according to their admission PASP result, and the primary end point was cardiac death in 6 months after AMI. Pulmonary artery systolic pressure was associated with age, AMI site, Killip classification, and decreased ejection fraction. After adjustments for clinical and echocardiographic parameters in a Cox model, PASP was found to be significantly related to cardiac death. In receiver operating characteristic analysis, PASP >30 mm Hg had a sensitivity of 59.8% and a specificity of 62.5% for predicting 6-month cardiac death after AMI. In conclusion, PASP at the index admission may be a useful marker predicting short-term cardiac death. These results have implications for future research and management of patients with AMI.

Prognostic Value of Elevated Pulmonary Artery Systolic Pressure on Short Term in Patients With Acute Myocardial Infarction

“…We read with interest the article entitled "Effect of Elevated Pulmonary Artery Systolic Pressure on Short-Term Prognosis in Patients With Acute Myocardial Infarction" by Fan et al 1 The authors 1 concluded that pulmonary artery systolic pressure (PASP) was an independent risk factor for 6-month cardiac death in patients with acute myocardial infarction (AMI). Pulmonary artery systolic pressure was associated with age, Killip classification, and decreased ejection fraction.…”

“…They 1 included 5401 patients (age range of 21-96 years), consisting of acute ST-segment elevation myocardial infarction (n ¼ 2539) and acute non-ST-segment elevation myocardial infarction (n ¼ 2862). Transthoracic echocardiographic measurement of PASP was measured within 48 hours after admission.…”

“…We read with interest the article entitled “Effect of Elevated Pulmonary Artery Systolic Pressure on Short-Term Prognosis in Patients With Acute Myocardial Infarction” by Fan et al 1…”

“…The authors 1 concluded that pulmonary artery systolic pressure (PASP) was an independent risk factor for 6-month cardiac death in patients with acute myocardial infarction (AMI). Pulmonary artery systolic pressure was associated with age, Killip classification, and decreased ejection fraction.…”

Reply to the Letter to the Editor Entitled “Prognostic Value of Elevated Pulmonary Artery Systolic Pressure on Short Term in Patients With Acute Myocardial Infarction”

“…We appreciate the comments of Pamukcu and Acikel 1 about our paper entitled “Effect of Elevated Pulmonary Artery Systolic Pressure on Short-Term Prognosis in Patients with Acute Myocardial Infarction.” 2 We would like to state that this was a retrospective study, which mainly reflected the independent effect of pulmonary artery systolic pressure (PASP) on short-term death, without further subgroup analysis, such as the analysis of association between PASP and acute myocardial infarction (AMI) site, revascularization time, or diuretics.…”