title: Relationship Between Mean Blood Pressure at Admission and In-Hospital Outcome After Primary Percutaneous Coronary Intervention for Acute Myocardial Infarction.
abstract: A J-shaped or U-shaped curve phenomenon might exist between systolic blood pressure (SBP) or pulse pressure (PP) at admission and in-hospital mortality in Japanese patients with acute myocardial infarction (AMI) undergoing primary percutaneous coronary intervention (PCI). However, data regarding a relationship between mean blood pressure (MBP) at admission and in-hospital outcome in AMI patients undergoing primary PCI are still lacking in Japan.A total of 1,413 primary PCI-treated AMI patients were classified into quintiles based on admission MBP (< 79 n = 283, 79-91 n = 285, 92-103 n = 285, 104-115 n = 279, and ≥ 116 mmHg n = 281). Patients with MBP < 79 mmHg had a significantly higher in-hospital mortality, while mortality was not significantly different among the other quintiles: 16.6% (< 79), 4.9% (79-91), 3.9% (92-103), 3.2% (104-115), and 5.0% (≥ 116 mmHg). On multivariate analysis, Killip class ≥ 3 at admission, LMT or multivessels as culprit lesions, admission MBP < 79 mmHg, and age were independent positive predictors of in-hospital mortality, whereas hypercholesterolemia and TIMI 3 flow before/after PCI were negative predictors, while the other MBP categories were not.These results suggest that admission MBP < 79 mmHg might be associated with in-hospital death, and the in-hospital prognostic effects of MBP, the steady component of blood pressure, at admission might be different from those of SBP or PP, the pulsatile component of blood pressure, at admission in Japanese AMI patients undergoing primary PCI.
authors.affiliation: Department of Cardiology, Kyoto First Red Cross Hospital.
authors.forename: Jun
authors.initials: J
authors.lastname: Shiraishi
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nakamura
authors.forename: Akira
authors.initials: A
authors.lastname: Shikuma
authors.forename: Keisuke
authors.initials: K
authors.lastname: Shoji
authors.forename: Marie
authors.initials: M
authors.lastname: Nishikawa
authors.forename: Takashi
authors.initials: T
authors.lastname: Yanagiuchi
authors.forename: Daisuke
authors.initials: D
authors.lastname: Ito
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Kimura
authors.forename: Eigo
authors.initials: E
authors.lastname: Kishita
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Nakagawa
authors.forename: Masayuki
authors.initials: M
authors.lastname: Hyogo
authors.forename: Takahisa
authors.initials: T
authors.lastname: Sawada
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: Yoshio
authors.initials: Y
authors.lastname: Kohno
authors.forename: Keizo
authors.initials: K
authors.lastname: Furukawa
authors.forename: Satoaki
authors.initials: S
authors.lastname: Matoba
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D003955:Diagnostic Tests, Routine; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality / Q000503:physiopathology* / Q000601:surgery*; D062645:Percutaneous Coronary Intervention; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome