Prognostic impact of blood pressure and heart rate at admission on in-hospital mortality after primary percutaneous intervention for acute myocardial infaction with ST-segment elevation in Western Romania

Objective: The purpose of this retrospective study was to evaluate the prognostic impact of systolic blood pre-ssure (SBP) and heart rate (HR) on in-hospital morta-lity in ST-segment elevation acute myocardial infarcti-on (STEMI) patients, after primary percutaneous inter-vention (PCI).

Methods: The study included 294 patients admitted for STEMI. They were divided into five groups according to the SBP at admission: group I, <105 mmHg; group II, 105-125 mmHg; group III, 126-140 mmHg; group IV, 141-158 mmHg; and group V, ≥159 mmHg. Incre-ased HR was defined as ≥ 80 beats per minute (bpm). In-hospital death was defined as all-cause death during admission and classified into cardiac and noncardiac death.

Results: Among the 294 patients admitted for STEMI, 218 (74%) were men. The mean age was 62 ± 17 years. In-hospital mortality rate was 6% (n=18), with 11 (3.7%) deaths having cardiac causes. The highest mor-tality was registered in group I (n=9, 16%, P=0.018). Compared to the other groups, group I patients were ol-der (P=0.033), more often smokers (P=0.026), and had a history of myocardial infarction (P=0.003), systemic hypertension (P=0.023), diabetes (P=0.041), or chronic kidney disease (P=0.0200).They more often had a HR ≥ 80 bpm (P=0.028) and a Killip class 3 or 4 at admission (P=0.020). The peak creatine phosphokinase-MB level was significantly higher in this group (P=0.005), while the angiographic findings more often identified as cul-prit lesions were the right coronary artery (P=0.005), the left main trunk (P=0.040), or a multivessel coro-nary artery disease (P=0.044). Multivariate analysis showed that group I patients had a significantly higher risk for both all-cause death (p=0.006) and cardiac death (p=0.003). Patients with HR ≥80 bpm also had higher mortality rates (p=0.0272 for general mortality and p=0.0280 for cardiac mortality).Comparison of re-ceiver operating characteristic curves of independent variables predictive of in-hospital all-cause death risk. Conclusions: The present study suggests that SBP<105 mmHg and HR ≥80 bpm at admission of STEMI pa-tients are associated with a higher risk of in-hospital death, even after primary PCI.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
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CODE: 379
CME Credits: 10 (Romanian College of Physicians)