title: Prognostic impact of pulse pressure at admission on in-hospital outcome after primary percutaneous coronary intervention for acute myocardial infarction.
abstract: Data regarding relationship between pulse pressure (PP) at admission and in-hospital outcome in patients with acute myocardial infarction (AMI) undergoing primary percutaneous coronary intervention (PCI) are still lacking. A total of 1413 primary PCI-treated AMI patients were classified into quintiles based on admission PP (<40, n = 280; 40-48, n = 276; 49-57, n = 288; 58-70, n = 288; and ≥71 mmHg, n = 281). The patients with PP < 40 mmHg tended to have higher prevalence of male, smoking, and 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/after primary PCI; and higher value of peak creatine phosphokinase concentration. Patients with PP < 40 mmHg had highest mortality, while patients with PP 49-57 mmHg had the lowest: 11.8 % (<40), 7.2 % (40-48), 2.8 % (49-57), 5.9 % (58-70), and 6.0 % (≥71 mmHg). On multivariate analysis, Killip class ≥3 at admission, LMT or multivessels as culprit lesions, chronic kidney disease, and age were the independent positive predictors of the in-hospital mortality, whereas admission PP 49-57 mmHg, hypercholesterolemia, and TIMI 3 flow before/after PCI were the negative ones, but admission PP < 40 mmHg was not. These results suggest that admission PP 49-57 mmHg might be correlated with better in-hospital prognosis in Japanese AMI patients undergoing primary PCI.
authors.affiliation: Department of Cardiology, Kyoto First Red Cross Hospital, Honmachi, Higashiyama-ku, Kyoto, 605-0981, 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
authors.initials: S
authors.lastname: Hashimoto
authors.forename: Daisuke
authors.initials: D
authors.lastname: Ito
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Kimura
authors.forename: Akihiro
authors.initials: A
authors.lastname: Matsui
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Yokoi
authors.forename: Masayasu
authors.initials: M
authors.lastname: Arihara
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Irie
authors.forename: Masayuki
authors.initials: M
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
authors.initials: A
authors.lastname: Matsumuro
authors.forename: Takeshi
authors.initials: T
authors.lastname: Shirayama
authors.forename: Makoto
authors.initials: M
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; D000369:Aged, 80 and over; D001794:Blood Pressure; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D007564:Japan; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D016017:Odds Ratio; D010343:Patient Admission; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome