Limits...
Impact of high-normal blood pressure measured in emergency room on adverse cardiac events in acute myocardial infarction.

Yoon NS, Jeong MH, Ahn Y, Kim JH, Chae SC, Kim YJ, Hur SH, Seong IW, Hong TJ, Choi D, Cho MC, Kim CJ, Seung KB, Chung WS, Jang YS, Cho JG, Park SJ, Other Korea Acute Myocardial Infarction Registry Investigato - Korean Circ J (2012)

Bottom Line: Compared with normal BP, the odds ratio for patients with high-normal BP was 1.147 (p=0.045, 95% confidence interval 1.011-1.402) for 6-month MACE.Even though high-normal BP patients had a better baseline clinical status, the prognosis was poorer than patients with normal BP.Therapeutic BP target goal for the patients with acute myocardial infarction should be <140/90 mm Hg, which is recommended in JNC7.

View Article: PubMed Central - PubMed

Affiliation: The Heart Center of Chonnam National University Hospital, Gwangju, Korea.

ABSTRACT

Background and objectives: Prehypertension according to JNC7 is common and is associated with increased vascular mortality. The importance of management in high-normal blood pressure (BP) is underemphasized.

Subjects and methods: We analyzed major adverse cardiac events (MACEs) in the Korea Acute Myocardial Infarction Registry in normal BP (group I) and high-normal BP (group II) patients.

Results: Among 14871 patients, 159 (61±12.3 years, 122 males) satisfied the study indication. Six-month and one-year clinical follow-up rate was 88.9% and 85.8%, respectively. Group I had 78 patients (60.9±12.4 years). Group II had 81 patients (61.6±12.5 years). Demographics of patients were not different between groups. Treatment strategy was not different. Initial Thrombolysis in Myocardial Infarction flow grade 0 was less frequent in group II (n=32, 47.1%) than in group I (n=16, 21.9%) (p=0.001). Successful intervention rate was not different between group II (93.8%) and group I (97.1%) (p=0.590). Six-month MACE occurred in 3 patients in group I (4.4%) and 10 in group II (15.6%) (p=0.031). Compared with normal BP, the odds ratio for patients with high-normal BP was 1.147 (p=0.045, 95% confidence interval 1.011-1.402) for 6-month MACE.

Conclusion: Even though high-normal BP patients had a better baseline clinical status, the prognosis was poorer than patients with normal BP. Therapeutic BP target goal for the patients with acute myocardial infarction should be <140/90 mm Hg, which is recommended in JNC7.

No MeSH data available.


Related in: MedlinePlus

Cumulative major adverse cardiac events (MACE) free survival in group I (solid black line, normal blood pressure) and group II (dotted black line, high-normal blood pressure) using Kaplan-Meier analysis.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC3369961&req=5

Figure 1: Cumulative major adverse cardiac events (MACE) free survival in group I (solid black line, normal blood pressure) and group II (dotted black line, high-normal blood pressure) using Kaplan-Meier analysis.

Mentions: The later 10 included three (4.7%) cardiac deaths, five (7.8%) repeat PCIs, and two (3.1%) coronary artery bypass grafts. One-year clinical follow-up rate were 85.8%. Seventeen (13.6%) developed MACE 1 year after the index treatment. The former six included one (1.5%) cardiac death, four (6.0%) repeat PCIs, and one (1.5%) coronary artery bypass graft. The later 11 included 3 (5.2%) cardiac deaths, six (10.3%) repeat PCIs, and two (3.4%) coronary artery bypass grafts. Cumulative MACEs-free survival was better in group I than in group II (p=0.049) (Fig. 1).


Impact of high-normal blood pressure measured in emergency room on adverse cardiac events in acute myocardial infarction.

Yoon NS, Jeong MH, Ahn Y, Kim JH, Chae SC, Kim YJ, Hur SH, Seong IW, Hong TJ, Choi D, Cho MC, Kim CJ, Seung KB, Chung WS, Jang YS, Cho JG, Park SJ, Other Korea Acute Myocardial Infarction Registry Investigato - Korean Circ J (2012)

Cumulative major adverse cardiac events (MACE) free survival in group I (solid black line, normal blood pressure) and group II (dotted black line, high-normal blood pressure) using Kaplan-Meier analysis.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3369961&req=5

Figure 1: Cumulative major adverse cardiac events (MACE) free survival in group I (solid black line, normal blood pressure) and group II (dotted black line, high-normal blood pressure) using Kaplan-Meier analysis.
Mentions: The later 10 included three (4.7%) cardiac deaths, five (7.8%) repeat PCIs, and two (3.1%) coronary artery bypass grafts. One-year clinical follow-up rate were 85.8%. Seventeen (13.6%) developed MACE 1 year after the index treatment. The former six included one (1.5%) cardiac death, four (6.0%) repeat PCIs, and one (1.5%) coronary artery bypass graft. The later 11 included 3 (5.2%) cardiac deaths, six (10.3%) repeat PCIs, and two (3.4%) coronary artery bypass grafts. Cumulative MACEs-free survival was better in group I than in group II (p=0.049) (Fig. 1).

Bottom Line: Compared with normal BP, the odds ratio for patients with high-normal BP was 1.147 (p=0.045, 95% confidence interval 1.011-1.402) for 6-month MACE.Even though high-normal BP patients had a better baseline clinical status, the prognosis was poorer than patients with normal BP.Therapeutic BP target goal for the patients with acute myocardial infarction should be <140/90 mm Hg, which is recommended in JNC7.

View Article: PubMed Central - PubMed

Affiliation: The Heart Center of Chonnam National University Hospital, Gwangju, Korea.

ABSTRACT

Background and objectives: Prehypertension according to JNC7 is common and is associated with increased vascular mortality. The importance of management in high-normal blood pressure (BP) is underemphasized.

Subjects and methods: We analyzed major adverse cardiac events (MACEs) in the Korea Acute Myocardial Infarction Registry in normal BP (group I) and high-normal BP (group II) patients.

Results: Among 14871 patients, 159 (61±12.3 years, 122 males) satisfied the study indication. Six-month and one-year clinical follow-up rate was 88.9% and 85.8%, respectively. Group I had 78 patients (60.9±12.4 years). Group II had 81 patients (61.6±12.5 years). Demographics of patients were not different between groups. Treatment strategy was not different. Initial Thrombolysis in Myocardial Infarction flow grade 0 was less frequent in group II (n=32, 47.1%) than in group I (n=16, 21.9%) (p=0.001). Successful intervention rate was not different between group II (93.8%) and group I (97.1%) (p=0.590). Six-month MACE occurred in 3 patients in group I (4.4%) and 10 in group II (15.6%) (p=0.031). Compared with normal BP, the odds ratio for patients with high-normal BP was 1.147 (p=0.045, 95% confidence interval 1.011-1.402) for 6-month MACE.

Conclusion: Even though high-normal BP patients had a better baseline clinical status, the prognosis was poorer than patients with normal BP. Therapeutic BP target goal for the patients with acute myocardial infarction should be <140/90 mm Hg, which is recommended in JNC7.

No MeSH data available.


Related in: MedlinePlus