Impact of hypertension on infarct size in ST elevation myocardial infarction patients undergoing primary angioplasty.
BACKGROUND
Hypertension is a well known risk factor for atherosclerosis. However, data on the impact of hypertension in patients with ST-segment elevation myocardial infarction (STEMI) are inconsistent, and mainly related to studies performed in the thrombolytic era, with very few data on patients undergoing primary angioplasty. The aim of the current study was to evaluate the impact of hypertension on scintigraphic infarct size in STEMI patients undergoing primary percutaneous coronary intervention (PCI).


METHODS
Our population is represented by 830 STEMI patients undergoing primary PCI. Infarct size was evaluated at 30 days by technetium-99m-sestamibi.


RESULTS
Hypertension was associated with more advanced age (P<0.001), a larger prevalence of diabetes (P=0.001), female sex (P<0.001), but lower prevalence of smoking (P<0.001) and anterior infarction (P=0.042). No difference was observed in ischemia time, cardiogenic shock at presentation, in preprocedural thrombolysis in myocardial infarction (TIMI) flow, and collateral circulation. Hypertension did not affect the rate of postprocedural TIMI 3 flow. Hypertension did not affect infarct size [12.5% (4.1-23.8%) vs. 12.8% (4.3-24.7%), P=0.38]. Similar results were observed in subanalyses in major high-risk subgroups. No impact of hypertension on infarct size was confirmed when the analysis was conducted according to the percentage of patients with infarct size above the median [adjusted odds ratio (95% CI)=0.97 (0.72-1.33), P=0.92].


CONCLUSIONS
This study shows that among STEMI patients, undergoing primary PCI hypertension does not affect scintigraphic infarct size.
aDivision of Cardiology, 'Maggiore della Carità' Hospital, Eastern Piedmont University, Novara bDivision of Cardiology, Careggi Hospital cNuclear Medicine Unit, University of Florence, Florence, Italy.
Giuseppe
G
De Luca
Guido
G
Parodi
Roberto
R
Sciagrà
Benedetta
B
Bellandi
Vincenzo
V
Comito
Ruben
R
Vergara
Angela
A
Migliorini
Renato
R
Valenti
David
D
Antoniucci
D000368:Aged; D017130:Angioplasty; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000503:physiopathology*