Prognostic value of a history of hypertension in 11,483 patients with acute myocardial infarction treated with thrombolysis. GISSI-2 Investigators. Gruppo Italiano per lo Studio della, Sopravvivena nell'Infarto Miocardico.
OBJECTIVE
To assess the prognostic value of a history of hypertension in patients with acute myocardial infarction (AMI) treated with thrombolysis.


METHODS
Retrospective adjusted analysis of outcome data of patients with AMI randomly allocated to treatment in a controlled study of alteplase versus streptokinase and heparin versus no heparin.


METHODS
A highly representative sample (about 90%) of Italian Coronary Care Units.


METHODS
Patients with (n = 3306) and without (n = 7406) a history of treated hypertension.


METHODS
Morbidity and mortality during hospital stay and the next 6 months.


RESULTS
Patients with a history of hypertension had a significantly higher mortality, both in hospital and during the next 6 months. The difference persisted also after a multivariate analysis including all major prognostic factors for in-hospital and 6-month mortality, respectively. Left ventricular failure and recurrent ischaemic events (angina and re-infarction) were also significantly more frequent in hypertensives both during their hospital stay and during follow-up study.


CONCLUSIONS
A history of hypertension is a negative independent prognostic factor after acute myocardial infarction treated with thrombolysis.
Fresco
C
C
Istituto di Cardiologia, O.C. Udine, Milano, Italy.
Avanzini
F
F
Bosi
S
S
Franzosi
M G
MG
Maggioni
A P
AP
Santoro
L
L
Bellanti
G
G
D000368:Aged; D005260:Female; D017052:Hospital Mortality; D006760:Hospitalization; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000453:epidemiology; D008297:Male; D008499:Medical Records; D009017:Morbidity; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000150:complications / Q000628:therapy*; D011379:Prognosis; D012307:Risk Factors; D016019:Survival Analysis; D015912:Thrombolytic Therapy