PMID- 23910428
OWN - NLM
STAT- MEDLINE
DCOM- 20131203
LR  - 20141120
IS  - 1879-1913 (Electronic)
IS  - 0002-9149 (Linking)
VI  - 112
IP  - 8
DP  - 2013 Oct 15
TI  - Impact of hypertension on distal embolization, myocardial perfusion, and 
      mortality in patients with ST segment elevation myocardial infarction undergoing 
      primary angioplasty.
PG  - 1083-6
LID - S0002-9149(13)01278-2 [pii]
LID - 10.1016/j.amjcard.2013.05.053 [doi]
AB  - Hypertension is a well-known risk factor for atherosclerosis. However, data on 
      the impact of hypertension in patients with ST 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 present study was to evaluate the impact of hypertension on distal 
      embolization, myocardial perfusion, and mortality in patients with STEMI 
      undergoing primary percutaneous coronary intervention. Our population is 
      represented by 1,662 patients undergoing primary angioplasty for STEMI included 
      in the Early Glycoprotein IIb-IIIa inhibitors in Primary angioplasty database. 
      Myocardial perfusion was evaluated by myocardial blush grade and ST segment 
      resolution. Follow-up data were collected within 1 year after primary 
      angioplasty. Hypertension was observed in 700 patients (42.1%). Hypertension was 
      associated with more advanced age (p <0.001), female gender (p <0.001), diabetes 
      (p <0.001), hypercholesterolemia (p <0.001), previous revascularization (p 
      <0.001), anterior myocardial infarction (p = 0.006), longer ischemia time (p = 
      0.03), more extensive coronary artery disease (p = 0.002), more often treated 
      with abciximab (p <0.001), and less often smokers (p <0.001). Hypertension was 
      associated with impaired postprocedural myocardial blush grade 2 to 3 (68.2% vs 
      74.2%, p = 0.019) and complete ST segment resolution (51.7% vs 61.1%, p = 0.001). 
      By a mean follow-up of 206 +/- 158 days, 70 patients (4.3%) had died. Hypertension 
      was associated with a greater mortality (6.2% vs 2.9%, hazard ratio 2.31, 95% 
      confidence interval 1.42 to 3.73, p <0.001), confirmed after correction for 
      baseline confounding factors (hazard ratio 1.82, 95% confidence interval 1.03 to 
      3.22, p <0.001). In conclusion, this study showed that among patients with STEMI 
      undergoing primary angioplasty, hypertension is associated with impaired 
      reperfusion and independently predicts 1-year mortality.
CI  - Copyright (c) 2013 Elsevier Inc. All rights reserved.
FAU - De Luca, Giuseppe
AU  - De Luca G
AD  - Division of Cardiology, "Maggiore della Carita" Hospital, Eastern Piedmont 
      University, Novara, Italy. Electronic address: 
      giuseppe.deluca@maggioreosp.novara.it.
FAU - van't Hof, Arnoud W J
AU  - van't Hof AW
FAU - Huber, Kurt
AU  - Huber K
FAU - Gibson, C Michael
AU  - Gibson CM
FAU - Bellandi, Francesco
AU  - Bellandi F
FAU - Arntz, Hans-Richard
AU  - Arntz HR
FAU - Maioli, Mauro
AU  - Maioli M
FAU - Noc, Marko
AU  - Noc M
FAU - Zorman, Simona
AU  - Zorman S
FAU - Zeymer, Uwe
AU  - Zeymer U
FAU - Gabriel, H Mesquita
AU  - Gabriel HM
FAU - Emre, Ayse
AU  - Emre A
FAU - Cutlip, Donald
AU  - Cutlip D
FAU - Rakowski, Tomasz
AU  - Rakowski T
FAU - Gyongyosi, Maryann
AU  - Gyongyosi M
FAU - Dudek, Dariusz
AU  - Dudek D
CN  - EGYPT cooperation
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
DEP - 20130801
PL  - United States
TA  - Am J Cardiol
JT  - The American journal of cardiology
JID - 0207277
SB  - IM
MH  - *Angioplasty, Balloon, Coronary
MH  - Coronary Circulation/*physiology
MH  - *Electrocardiography
MH  - Embolism/*epidemiology/etiology
MH  - Female
MH  - Follow-Up Studies
MH  - Global Health
MH  - Humans
MH  - Hypertension/complications/mortality/*physiopathology
MH  - Incidence
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/*mortality/physiopathology/surgery
MH  - Prognosis
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Survival Rate/trends
EDAT- 2013/08/06 06:00
MHDA- 2013/12/16 06:00
CRDT- 2013/08/06 06:00
PHST- 2013/03/26 00:00 [received]
PHST- 2013/05/20 00:00 [revised]
PHST- 2013/05/20 00:00 [accepted]
PHST- 2013/08/06 06:00 [entrez]
PHST- 2013/08/06 06:00 [pubmed]
PHST- 2013/12/16 06:00 [medline]
AID - S0002-9149(13)01278-2 [pii]
AID - 10.1016/j.amjcard.2013.05.053 [doi]
PST - ppublish
SO  - Am J Cardiol. 2013 Oct 15;112(8):1083-6. doi: 10.1016/j.amjcard.2013.05.053. Epub 
      2013 Aug 1.