title: The association between elevated admission systolic blood pressure in patients with acute coronary syndrome and favorable early and late outcomes.
abstract: In patients with acute coronary syndrome (ACS), the predictive potential of admission systolic blood pressure (SBP) on early and late outcomes is not entirely clear. We investigated the association between admission SBP in patients hospitalized for ACS and subsequent morbidity and mortality in a real world setting. The study population comprised 7645 ACS patients enrolled in the Acute Coronary Syndromes Israeli Survey (ACSIS) between 2002 and 2010. We analyzed the association between admission SBP, and the rates of 7-day and 1-year all-cause mortality and of 30-day major cardiovascular adverse events (MACE). Admission SBP was categorized as low (<110 mm Hg), normal (110-140 mm Hg), high (141-160 mm Hg), and very high (>160 mm Hg). Compared with patients with normal admission SBP, those with low SBP had a significantly increased hazard ratios (HRs) for 7-day and 1-year mortality, and MACE of 2.37, 1.92, and 1.51, respectively (all P < .001). In contrast, patients with very high admission SBP had significantly decreased HRs for 7-day and 1-year mortality, and MACE of 0.46, 0.65, and 0.84, respectively (P = .004, <.001, and .07, respectively). In patients with ACS, elevated admission SBP is associated with favorable early and late outcomes.
authors: Department of Internal Medicine D and Hypertension Unit, Tel-Aviv University, Tel-Aviv, Israel; The Dr. Pinchas Borenstein Talpiot Medical Leadership Program, Tel-Aviv University, Tel-Aviv, Israel.
authors: Gadi
authors: G
authors: Shlomai
authors: Heart Institute and the Neufeld Cardiac Research Institute, Leviev Heart Center, The Chaim Sheba Medical Center, Tel-Hashomer, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors: Eran
authors: E
authors: Kopel
authors: Heart Institute and the Neufeld Cardiac Research Institute, Leviev Heart Center, The Chaim Sheba Medical Center, Tel-Hashomer, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors: Ilan
authors: I
authors: Goldenberg
authors: Department of Internal Medicine D and Hypertension Unit, Tel-Aviv University, Tel-Aviv, Israel. Electronic address: grosse@post.tau.ac.il.
authors: Ehud
authors: E
authors: Grossman
mesh_terms: D054058:Acute Coronary Syndrome / Q000401:mortality / Q000503:physiopathology*; D000368:Aged; D001794:Blood Pressure / Q000502:physiology*; D002423:Cause of Death / Q000639:trends; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D007557:Israel / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D013599:Systole; D013997:Time Factors
keywords: Cardiovascular event; mortality outcome; observational study