PMID- 21735205
OWN - NLM
STAT- MEDLINE
DCOM- 20121119
LR  - 20211020
IS  - 1615-2573 (Electronic)
IS  - 0910-8327 (Linking)
VI  - 27
IP  - 4
DP  - 2012 Jul
TI  - Impact of hypertension on short- and long-term prognoses in patients with ST 
      elevation myocardial infarction and without previously known diabetes.
PG  - 370-6
LID - 10.1007/s00380-011-0169-6 [doi]
AB  - Hypertension is well established as a risk factor for the development of 
      atherosclerosis. Data on the impact of hypertension in patients with ST elevation 
      myocardial infarction are so far inconsistent, and are mainly related to studies 
      performed in the thrombolytic era. We assessed the impact of hypertension over 
      the short and long term in 560 patients with ST elevation myocardial infarction 
      (STEMI) and without previously known diabetes, all of whom were submitted to 
      mechanical revascularization and consecutively admitted to our Intensive Cardiac 
      Care Unit. Hypertensive patients were older (p < 0.001), more frequently male 
      (0.005), and they showed a reduced eGFR (p < 0.001). Smoking was more frequent in 
      nonhypertensive patients (p < 0.001), while the incidence of three-vessel 
      coronary artery disease was higher in hypertensive patients (p = 0.003). No 
      difference in the in-hospital mortality rates for the two subgroups was detected. 
      At follow-up (median 32.5 months, 25th-75th percentile 16.9-47.3 months), 
      Kaplan-Meier survival analysis detected no differences in mortality between 
      hypertensive and nonhypertensive patients (log rank chi(2) 0.38, p = 0.538). 
      According to our data, obtained from a large series of consecutive STEMI patients 
      without previously known diabetes, all of whom were submitted to primary PCI, a 
      history of hypertension does not affect mortality over either the short or the 
      long term. Moreover, hypertensive patients showed an altered glucose response to 
      stress, as indicated by higher admission glucose values, poorer in-hospital 
      glucose control, and a higher incidence of acute insulin resistance (as indicated 
      by the HOMA index). Hypertensive patients therefore appear to warrant careful 
      metabolic management during their hospital courses.
FAU - Lazzeri, Chiara
AU  - Lazzeri C
AD  - Intensive Cardiac Care Unit, Heart and Vessel Department, Azienda 
      Ospedaliero-Universitaria Careggi, Viale Morgagni 85, 50134 Florence, Italy. 
      lazzeric@libero.it
FAU - Valente, Serafina
AU  - Valente S
FAU - Chiostri, Marco
AU  - Chiostri M
FAU - Attana, Paola
AU  - Attana P
FAU - Picariello, Claudio
AU  - Picariello C
FAU - Gensini, Gian Franco
AU  - Gensini GF
LA  - eng
PT  - Journal Article
DEP - 20110707
PL  - Japan
TA  - Heart Vessels
JT  - Heart and vessels
JID - 8511258
RN  - 0 (Blood Glucose)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Blood Glucose/metabolism
MH  - Chi-Square Distribution
MH  - Coronary Care Units
MH  - Diabetes Mellitus/diagnosis/*epidemiology/mortality/therapy
MH  - Female
MH  - Hospital Mortality
MH  - Hospitalization
MH  - Humans
MH  - Hypertension/diagnosis/*epidemiology/mortality/therapy
MH  - Insulin Resistance
MH  - Italy/epidemiology
MH  - Kaplan-Meier Estimate
MH  - Logistic Models
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/diagnosis/*epidemiology/mortality/therapy
MH  - Myocardial Revascularization
MH  - Odds Ratio
MH  - Risk Assessment
MH  - Risk Factors
MH  - Time Factors
MH  - Treatment Outcome
EDAT- 2011/07/08 06:00
MHDA- 2012/12/10 06:00
CRDT- 2011/07/08 06:00
PHST- 2011/02/16 00:00 [received]
PHST- 2011/06/09 00:00 [accepted]
PHST- 2011/07/08 06:00 [entrez]
PHST- 2011/07/08 06:00 [pubmed]
PHST- 2012/12/10 06:00 [medline]
AID - 10.1007/s00380-011-0169-6 [doi]
PST - ppublish
SO  - Heart Vessels. 2012 Jul;27(4):370-6. doi: 10.1007/s00380-011-0169-6. Epub 2011 
      Jul 7.