- 作者：Jun Shiraishi ; Yoshio Kohno ; Takahisa Sawada ; Sho Hashimoto ; Daisuke Ito ; Masayoshi Kimura ; Akihiro Matsui ; Hirokazu Yokoi ; Masayasu Arihara ; Hidekazu Irie ; Masayuki Hyogo ; Takatomo Shima ; Takeshi Nakamura ; Satoaki Matoba ; Hiroyuki Yamada ; Akiyoshi Matsumuro ; Takeshi Shirayama ; Makoto Kitamura ; Keizo Furukawa ; Hiroaki Matsubara ; et al.
- 关键词：Acute myocardial infarction ; Systolic blood pressure ; Prognosis
- 刊名：Journal of Cardiology
- 出版年：2012
- 出版时间：August, 2012
- 年：2012
- 卷：60
- 期：2
- 页码：139-144
- 全文大小：209 K
Summary
Background
Data regarding the relationship between systolic blood pressure (SBP) at admission and in-hospital outcome in patients with acute myocardial infarction (AMI) undergoing primary percutaneous coronary intervention (PCI) are still lacking in Japan.Methods and results
A total of 1475 primary PCI-treated AMI patients were classified into quintiles based on admission SBP (<105 mmHg, n = 300; 105-125 mmHg, n = 294; 126-140 mmHg, n = 306; 141-158 mmHg, n = 286; and ¡Ý159 mmHg n = 289). The patients with SBP < 105 mmHg tended to have higher age, previous myocardial infarction, chronic kidney disease (CKD), Killip class ¡Ý 3 at admission, right coronary artery, left main trunk (LMT), or multivessels as culprit lesions, larger number of diseased vessels, lower Thrombolysis In Myocardial Infarction (TIMI) grade in the infarct-related artery before primary PCI, and higher value of peak creatine phosphokinase concentration. Patients with SBP < 105 mmHg had a significantly higher mortality, while mortality was not significantly different among the other quintiles: 24.3 % (<105 mmHg), 4.8 % (105-125 mmHg), 4.9 % (126-140 mmHg), 2.8 % (141-158 mmHg), and 5.2 % (¡Ý159 mmHg) (p < 0.001). On multivariate analysis, Killip class ¡Ý 3 at admission, LMT or multivessels as culprit lesions, admission SBP < 105 mmHg, CKD, and age were the independent positive predictors of in-hospital mortality, whereas admission SBP 141-158 mmHg and TIMI 3 flow after PCI were the negative ones, but admission SBP 105-125 mmHg, admission SBP 126-140 mmHg, and admission SBP ¡Ý 159 mmHg were not.
Conclusions
These results suggest that admission SBP 141-158 mmHg might be correlated with better in-hospital prognosis, whereas admission SBP < 105 mmHg was associated with in-hospital death in Japanese AMI patients undergoing primary PCI.