PMID- 24852835 OWN - NLM STAT- MEDLINE DCOM- 20150207 LR - 20140616 IS - 1874-1754 (Electronic) IS - 0167-5273 (Linking) VI - 175 IP - 1 DP - 2014 Jul 15 TI - Impact of hypertension on clinical outcome in STEMI patients undergoing primary angioplasty with BMS or DES: insights from the DESERT cooperation. PG - 50-4 LID - S0167-5273(14)00862-6 [pii] LID - 10.1016/j.ijcard.2014.04.180 [doi] AB - BACKGROUND: Hypertension is a well known risk factor for atherosclerosis. However, data on the prognostic 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 in patients undergoing primary angioplasty. Therefore, the aim of the current study was to evaluate the impact hypertension on clinical outcome in STEMI patients undergoing primary PCI with BMS or DES. METHODS: Our population is represented by 6298 STEMI patients undergoing primary angioplasty included in the DESERT database from 11 randomized trials comparing DES vs BMS for STEMI. RESULTS: Hypertension was observed in 2764 patients (43.9%), and associated with ageing (p<0.0001), female gender (p<0.001), diabetes (p<0.0001), hypercholesterolemia (p<0.0001), previous MI (p=0.002), previous revascularization (p=0.002), longer time-to-treatment (p<0.001), preprocedural TIMI 3 flow, and with a lower prevalence of smoking (41% vs 53.9%, p<0.001) and anterior MI (42% vs 45.9%, p=0.002). Hypertension was associated with impaired postprocedural TIMI 0-2 flow (Adjusted OR [95% CI]=1.22 [1.01-1.47], p=0.034). At a follow-up of 1,201 +/- 440 days, hypertension was associated with higher mortality (adjusted HR [95% CI]=1.24 [1.01-1.54], p=0.048), reinfarction (adjusted HR [95% CI]=1.31 [1.03-1.66], p=0.027), stent thrombosis (adjusted HR [95% CI]=1.29 [0.98-1.71], p=0.068) and TVR (adjusted HR [95% CI]=1.22 [1.04-1.44], p=0.013). CONCLUSIONS: This study showed that among STEMI patients undergoing primary angioplasty with DES or BMS, hypertension is independently associated with impaired epicardial reperfusion, mortality, reinfarction and TVR, and a trend in higher ST. CI - Copyright (c) 2014 Elsevier Ireland Ltd. All rights reserved. FAU - De Luca, Giuseppe AU - De Luca G AD - Division of Cardiology, Ospedale "Maggiore della Carita", Eastern Piedmont University, Novara, Italy; Centro di Biotecnologie per la Ricerca Medica Applicata (BRMA), Eastern Piedmont University, Novara, Italy. Electronic address: giuseppe.deluca@maggioreosp.novara.it. FAU - Dirksen, Maurits T AU - Dirksen MT AD - Department of Interventional Cardiology, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands. FAU - Spaulding, Christian AU - Spaulding C AD - Assistance Publique-Hopitaux de Paris Cochin Hospital, Paris 5 Medical School Rene Descartes University and INSERM Unite 780 Avenir, Paris, France. FAU - Kelbaek, Henning AU - Kelbaek H AD - The Heart Center, Rigshospitalet, Copenhagen, Denmark. FAU - Schalij, Martin AU - Schalij M AD - Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands. FAU - Thuesen, Leif AU - Thuesen L AD - Cardiac Department, Skejby Hospital, Skejby, Denmark. FAU - van der Hoeven, Bas AU - van der Hoeven B AD - Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands. FAU - Vink, Marteen A AU - Vink MA AD - Department of Interventional Cardiology, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands. FAU - Kaiser, Christoph AU - Kaiser C AD - Department of Cardiology, University Hospital Basel, Switzerland. FAU - Musto, Carmine AU - Musto C AD - Division of Cardiology, San Camillo Hospital, Rome, Italy. FAU - Chechi, Tania AU - Chechi T AD - Ospedale Santa Maria Annunziata, Bagno a Ripoli, Florence, Italy. FAU - Spaziani, Gaia AU - Spaziani G AD - Ospedale Santa Maria Annunziata, Bagno a Ripoli, Florence, Italy. FAU - Diaz de la Llera, Luis Salvador AU - Diaz de la Llera LS AD - Hemodynamics and Interventional Cardiology Unit, University Hospital Virgen del Rocio, Seville, Spain. FAU - Pasceri, Vincenzo AU - Pasceri V AD - Interventional Cardiology Unit, San Filippo Neri Hospital, Rome, Italy. FAU - Di Lorenzo, Emilio AU - Di Lorenzo E AD - Division of Cardiology, "S.G. Moscati", Avellino, Italy. FAU - Violini, Roberto AU - Violini R AD - Division of Cardiology, San Camillo Hospital, Rome, Italy. FAU - Suryapranata, Harry AU - Suryapranata H AD - Department of Cardiology, UMC St Radboud, Nijmegen, The Netherlands. FAU - Stone, Gregg W AU - Stone GW AD - Columbia University Medical Center, New York City, NY, USA; Cardiovascular Research Foundation, New York City, NY, USA. CN - DESERT cooperation LA - eng PT - Journal Article PT - Meta-Analysis DEP - 20140426 PL - Netherlands TA - Int J Cardiol JT - International journal of cardiology JID - 8200291 RN - 0 (Metals) SB - IM MH - Aged MH - Angioplasty, Balloon, Coronary/*mortality/trends MH - *Drug-Eluting Stents/trends MH - Female MH - Follow-Up Studies MH - Humans MH - Hypertension/diagnosis/*mortality/*surgery MH - Male MH - Metals MH - Middle Aged MH - Myocardial Infarction/diagnosis/*mortality/*surgery MH - Randomized Controlled Trials as Topic/mortality/trends MH - Treatment Outcome OTO - NOTNLM OT - BMS OT - DES OT - Hypertension OT - Primary angioplasty OT - ST elevation myocardial infarction EDAT- 2014/05/24 06:00 MHDA- 2015/02/11 06:00 CRDT- 2014/05/24 06:00 PHST- 2013/11/02 00:00 [received] PHST- 2014/03/30 00:00 [revised] PHST- 2014/04/17 00:00 [accepted] PHST- 2014/05/24 06:00 [entrez] PHST- 2014/05/24 06:00 [pubmed] PHST- 2015/02/11 06:00 [medline] AID - S0167-5273(14)00862-6 [pii] AID - 10.1016/j.ijcard.2014.04.180 [doi] PST - ppublish SO - Int J Cardiol. 2014 Jul 15;175(1):50-4. doi: 10.1016/j.ijcard.2014.04.180. Epub 2014 Apr 26.