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

Abstract：

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.

journal_name

J Cardiol

journal_title

Journal of cardiology

authors

Shiraishi J,Kohno Y,Sawada T,Ito D,Kimura M,Ariyoshi M,Matsui A,Arihara M,Irie H,Hyogo M,Shima T,Nakamura T,Matoba S,Yamada H,Matsumuro A,Shirayama T,Kitamura M,Furukawa K,Matsubara H

doi

10.1016/j.jjcc.2011.04.003

subject

Has Abstract

pub_date

2011-07-01 00:00:00

pages

54-60

issue

eissn

0914-5087

issn

1876-4738

pii

S0914-5087(11)00086-4

journal_volume

pub_type

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