title: Prognostic impact of systolic blood pressure at admission on in-hospital outcome after primary percutaneous coronary intervention for acute myocardial infarction.
abstract: 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.
  
  
  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 ≥159 mmHg n=289). The patients with SBP<105 mmHg tended to have higher age, previous myocardial infarction, chronic kidney disease (CKD), Killip class≥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% (≥159 mmHg) (p<0.001). On multivariate analysis, Killip class≥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≥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.
authors.affiliation: Department of Cardiology, Kyoto First Red Cross Hospital, Japan. risa11221998@yahoo.co.jp
authors.forename: Jun
authors.initials: J
authors.lastname: Shiraishi
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Kohno
authors.forename: Takahisa
authors.initials: T
authors.lastname: Sawada
authors.forename: Sho
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authors.lastname: Hashimoto
authors.forename: Daisuke
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authors.lastname: Ito
authors.forename: Masayoshi
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authors.lastname: Kimura
authors.forename: Akihiro
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authors.lastname: Matsui
authors.forename: Hirokazu
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authors.lastname: Yokoi
authors.forename: Masayasu
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authors.lastname: Arihara
authors.forename: Hidekazu
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authors.lastname: Irie
authors.forename: Masayuki
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authors.lastname: Hyogo
authors.forename: Takatomo
authors.initials: T
authors.lastname: Shima
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nakamura
authors.forename: Satoaki
authors.initials: S
authors.lastname: Matoba
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yamada
authors.forename: Akiyoshi
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authors.lastname: Matsumuro
authors.forename: Takeshi
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authors.lastname: Shirayama
authors.forename: Makoto
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authors.lastname: Kitamura
authors.forename: Keizo
authors.initials: K
authors.lastname: Furukawa
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Matsubara
mesh_terms: D000368:Aged; D001794:Blood Pressure; D017023:Coronary Angiography; D003955:Diagnostic Tests, Routine; D005260:Female; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000401:mortality / Q000601:surgery*; D062645:Percutaneous Coronary Intervention; D011379:Prognosis; D012307:Risk Factors; D013599:Systole; D016896:Treatment Outcome