Systolic blood pressure at admission, clinical manifestations, and in-hospital outcomes in patients with acute myocardial infarction

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• 作者：Jun Shiraishi MD ; PhD^a ; ¹ ; ^{risa11221998@yahoo.co.jp"" rel=""nofollow} ; Yoshio Kohno MD ; PhD^a ; ¹ ; Takahisa Sawada MD ; PhD ; FJCC^b ; ¹ ; Daisuke Ito MD^a ; ¹ ; Masayoshi Kimura MD^a ; ¹ ; Makoto Ariyoshi MD^a ; ¹ ; Akihiro Matsui MD ; PhD^a ; ¹ ; Masayasu Arihara MD^c ; ¹ ; Hidekazu Irie MD ; PhD^a ; ¹ ; Masayuki Hyogo MD^a ; ¹ ; Takatomo Shima MD ; PhD^a ; ¹ ; Takeshi Nakamura MD ; PhD^b ; ¹ ; Satoaki Matoba MD ; PhD^b ; ¹ ; Hiroyuki Yamada MD ; PhD^b ; ¹ ; Akiyoshi Matsumuro MD^b ; ¹ ; Takeshi Shirayama MD ; PhD^b ; ¹ ; Makoto Kitamura MD ; PhD^d ; ¹ ; Keizo Furukawa MD ; PhD ; FJCC^e ; ¹ ; Hiroaki Matsubara MD ; PhD^b ; ¹
• 关键词：Acute myocardial infarction ; Systolic blood pressure ; Prognosis
• 刊名：Journal of Cardiology
• 出版年：2011
• 出版时间：July 2011
• 年：2011
• 卷：58
• 期：1
• 页码：54-60
• 全文大小：237 K

文摘

Summary

Background

Several clinical studies have demonstrated an inverse relationship between systolic blood pressure (SBP) at admission and in-hospital mortality in patients hospitalized for acute myocardial infarction (AMI). However, data on the relation between admission SBP and in-hospital prognosis in AMI patients are still lacking in Japan.

Methods and results

A total of 1211 AMI patients were classified into quintiles based on SBP at hospital admission (<106 mmHg, n = 241; 106–125 mmHg, n = 239; 126–140 mmHg, n = 244; 141–159 mmHg, n = 238; and ≥160 mmHg, n = 249). The patients with SBP <106 mmHg tended to have higher age, Killip class ≥3 at admission, right coronary artery, left main trunk, or multivessels as culprit lesions, larger number of diseased vessels, lower Thrombolysis In Myocardial Infarction grade in the infarct-related artery before primary percutaneous coronary intervention (PCI), and higher value of peak creatine phosphokinase concentration. Patients with SBP <106 mmHg had a significantly higher mortality, while mortality was not significantly different among the other quintiles: 25.7 % (<106 mmHg), 5.4 % (106–125 mmHg), 5.7 % (126–140 mmHg), 2.5 % (141–159 mmHg), and 5.6 % (≥160 mmHg) (p < 0.001). On multivariate analysis, Killip class ≥3 at admission, admission SBP <106 mmHg, and age were the independent positive predictors of in-hospital mortality, whereas admission SBP 141–159 mmHg and primary PCI were the negative ones, but admission SBP 106–125 mmHg, admission SBP 126–140 mmHg, and admission SBP ≥160 mmHg were not.

Conclusions

These results suggest that admission SBP 141–159 mmHg might be correlated with better in-hospital prognosis, whereas admission SBP <106 mmHg was associated with in-hospital death in Japanese patients hospitalized for AMI.