Impact of Hypertension History on Short and Long-Term Prognosis in Patients with Acute Myocardial Infarction Treated with Percutaneous Angioplasty: Comparison Between STEMI and NSTEMI

Cecchi, Emanuele; DʼAlfonso, Maria Grazia; Chiostri, Marco; Parigi, Elena; Landi, Daniele; Valente, Serafina; Romano, Salvatore Mario; Gensini, Gian Franco; Giglioli, Cristina

doi:10.1007/s40292-013-0032-1

Cited by 19 publications

(17 citation statements)

References 23 publications

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“…Lazzeri et al 36 assessed the influence of hypertension on the short-term and long-term outcome in 560 patients with STEMI submitted to mechanical revascularisation and found that a history of hypertension had no affect on either short-term or long-term mortality. Similar results were also found in Cecchi et al 's report 37. The reason why hypertension has no significant influence on the outcome in patients with STEMI who undergo PCI may be multifactorial.…”

Section: Discussionsupporting

confidence: 87%

“…One possible interpretation is that patients with hypertensive STEMI did not show a larger infarct size compared with normotensive patients, depicted by De Luca G et al 's study 38. Another possible explanation was the altered lifestyle and standard antihypertensive therapy after STEMI which controlled the main cardiovascular risk factors and resulted in a relatively fair outcome 37. However, although hypertension appeared to have no impact on the outcome in patients with STEMI who underwent PCI, patients with hypertension showed an altered glucose response to stress, as indicated by a higher incidence of acute insulin resistance and higher admission glucose values, which has been demonstrated to be a risk factor for 1-year mortality in patients with STEMI who underwent PCI with estimated glomerular filtration rate ≥60 mL/min/m 2 39.…”

Section: Discussionmentioning

confidence: 95%

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Clinical characteristics and short-term outcomes in patients with elevated admission systolic blood pressure after acute ST-elevation myocardial infarction: a population-based study

et al. 2014

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ObjectivePrognostic value of lower admission systolic blood pressure (SBP) in patients with acute myocardial infarction has been confirmed, but the impact of elevated admission SBP on short-term outcomes has been evaluated only by a limited number of studies and they have reported conflicting results. The aim of our study was to investigate the characteristics and short-term outcomes in patients with elevated admission SBP after ST-elevation myocardial infarction (STEMI).DesignA population-based, observational study.SettingThe multicentre registry in China.ParticipantsA total of 7510 consecutive patients with STEMI were registered. Patients were divided into three groups according to admission SBP: normal admission SBP (100–139 mm Hg), modestly elevated admission SBP (140–179 mm Hg) and excessively elevated admission SBP (≥180 mm Hg). The primary outcomes were 7-day and 30-day all-cause mortality, major adverse cardiac events (MACE) and bleeding rate.ResultsOf 6591 patients, 4182 (63.5%) had normal admission SBP, 2187 (33.2%) modestly elevated admission SBP and 222 (3.4%) excessively elevated admission SBP. Patients with elevated admission SBP had a high-risk profile, such as were more likely to be older, with more concomitant cardiovascular morbidities, presenting with more events of anterior myocardial infarction and less reperfusion treatment. However, 7-day and 30-day all-cause mortality, MACE and bleeding rate were comparable among groups (all p>0.05). Survival curves and MACE curves were similar among groups (p=0.377 and 0.375, respectively). After multivariate adjustment, elevated admission SBP was not associated with increased risk of short-term death and bleeding, and MACE was comparable with normal admission SBP.ConclusionsAlthough those with elevated admission SBP after STEMI were at a higher risk for cardiovascular events, they did not have poorer short-term outcomes compared with patients with normal admission SBP.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 95%

Clinical characteristics and short-term outcomes in patients with elevated admission systolic blood pressure after acute ST-elevation myocardial infarction: a population-based study

et al. 2014

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“…Hypertension did not affect short-and long term mortality in patients with ST elevation myocardial infarction (STEMI) receiving PCI [2, 3]. However, hypertension was the only independent long-term predictor of mortality in patients with unstable angina (US) receiving coronary stenting [4].…”

Section: Introductionmentioning

confidence: 99%

Impact of diabetes and hypertension on cardiovascular outcomes in patients with coronary artery disease receiving percutaneous coronary intervention

Lin

Chen

Lin

et al. 2017

BMC Cardiovasc Disord

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BackgroundPercutaneous coronary intervention (PCI) is a necessary procedure commonly performed for patients with coronary artery disease (CAD). However, the impact of diabetes and hypertension on long-term outcomes of patients after receiving PCI has not yet been determined.MethodsThe data of 1234 patients who received PCI were collected prospectively, and patients were divided into four groups, including patients with and without DM and those with either DM or hypertension alone. Baseline characteristics, risk factors, medications and angiographic findings were compared and determinants of cardiovascular outcomes were analyzed in patients who received PCI.ResultsPatients with DM alone had the highest all-cause mortality (P < 0.001), cardiovascular mortality and myocardial infarctions (MI) (both P < 0.01) compared to the other groups. However, no differences were found between groups in repeat PCI (P = 0.32). Cox proportional hazard model revealed that age, chronic kidney disease (CKD), previous MI and stroke history were risk factors for all-cause mortality (OR: 1.05,1.89, 2.87, and 4.12, respectively), and use of beta-blockers (BB) and statins reduced all-cause mortality (OR: 0.47 and 0.35, respectively). Previous MI and stroke history, P2Y12 inhibitor use, and syntax scores all predicted CV mortality (OR: 4.02, 1.89, 2.87, and 1.04, respectively). Use of angiotensin converting enzyme inhibitors (ACEI), beta-blockers (BB), and statins appeared to reduce risk of CV death (OR: 0.37, 0.33, and 0.32, respectively). Previous MI and syntax scores predicted MI (OR: 3.17 and 1.03, respectively), and statin use reduced risk of MI (OR: 0.43). Smoking and BB use were associated with repeat PCI (OR: 1.48 and 1.56, respectively).ConclusionsAfter PCI, patients with DM alone have higher mortality compared to patients without DM and hypertension, with both DM and hypertension, and with hypertension alone. Comorbid hypertension does not appear to increase risk in DM patients, whereas comorbid DM appears to increase risk in hypertensive patients.Trial registrationREC103-15 IRB of Taichung Tzu-chi Hospital

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“…Similarly, Cecchi et al studied the differential effect of hypertension on prognosis among 1031 patients with STEMI and 437 patients with NSTEMI treated with PCI. Hypertension was not associated with in‐hospital or long‐term mortality in either groups after adjustment for other risk factors . On the other hand, Abrigagni et al studied 4994 patients with MI and documented that hypertensive patients presented less frequently with cardiogenic shock, atrioventricular block, ventricular fibrillation, cardiac rupture, and ventricular thrombosis.…”

Section: Hypertension History In Patients With Acute Coronary Syndromesmentioning

confidence: 97%

“…Hypertension was not associated with in-hospital or long-term mortality in either groups after adjustment for other risk factors. 29 On the other hand, Abrigagni et al studied 4994…”

Section: Hyperten S I On His Tory In Patients With Acute Coronary Smentioning

confidence: 99%

Hypertension and patients with acute coronary syndrome: Putting blood pressure levels into perspective

Κωνσταντίνου

Tsioufis

Koumelli

et al. 2019

J of Clinical Hypertension

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Arterial hypertension is a well‐established cardiovascular risk factor, and blood pressure (BP) control has largely improved the prognosis of hypertensive patients. A number of studies have assessed the role of BP levels in the prognosis of patients with acute coronary syndromes. Pathophysiologic links of hypertension to acute myocardial infarction (MI) include endothelial dysfunction, autonomic nervous system dysregulation, impaired vasoreactivity, and a genetic substrate. A history of hypertension is highly prevalent among patients presenting with MI, and some, but not all, studies have associated it with a worse prognosis. Some data support that low levels of admission and in‐hospital BP may indicate an increased risk for subsequent events. Risk scores used in patients with MI have, therefore, included BP levels and a history of hypertension in their variables. Of note, good long‐term BP control, ideally initiated prior to discharge, should be pursued in order to improve secondary prevention.

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Impact of Hypertension History on Short and Long-Term Prognosis in Patients with Acute Myocardial Infarction Treated with Percutaneous Angioplasty: Comparison Between STEMI and NSTEMI

Cited by 19 publications

References 23 publications

Clinical characteristics and short-term outcomes in patients with elevated admission systolic blood pressure after acute ST-elevation myocardial infarction: a population-based study

Clinical characteristics and short-term outcomes in patients with elevated admission systolic blood pressure after acute ST-elevation myocardial infarction: a population-based study

Impact of diabetes and hypertension on cardiovascular outcomes in patients with coronary artery disease receiving percutaneous coronary intervention

Hypertension and patients with acute coronary syndrome: Putting blood pressure levels into perspective

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