Comparison of 4 Admission Blood Pressure Indexes for Predicting
                    30-Day Mortality in Patients With ST-Segment Elevation Myocardial
                    Infarction

Ma, Wenfang; Liang, Yan; Zhu, Jun; Yang, Yanmin; Tan, Huiqiong; Yu, Litian; Gào, Xīn; Feng, Guangxun; Li, Jian Dong

doi:10.1093/ajh/hpv109

Cited by 20 publications

(17 citation statements)

References 30 publications

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“…Older age is an important predictor of worse outcomes in patients with STEMI, including death, bleeding, and ischemic events . As reported in previous studies, admission SBP and HR are predictors of in‐hospital and long‐term mortality . These two important hemodynamic parameters related to cardiovascular functions are closely associated.…”

Section: Discussionsupporting

confidence: 59%

“…14 As reported in previous studies, admission SBP and HR are predictors of in-hospital and long-term mortality. 15,16 These two important hemodynamic parameters related to cardiovascular functions are closely associated. The double product (DP), which includes both the values of SBP and HR, was initially calculated to indirectly assess myocardial oxygen uptake during stress testing.…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of a risk index for predicting short‐term and long‐term outcomes in patients with ST‐elevation myocardial infarction

Shao

Wang

et al. 2020

Cathet Cardio Intervent

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Objective This study aimed to evaluate the usefulness of the admission risk index (RI) to predict short‐term and long‐term outcomes in a broad population with ST‐elevation myocardial infarction (STEMI) using data from the Chinese Acute Myocardial Infarction Registry. Background The RI was developed as a simple tool to predict risk of death in STEMI patients. The performance in predicting short‐term and long‐term risk of death in Chinese patients receiving percutaneous coronary intervention and conservative treatment for STEMI remains unclear. Methods Age, heart rate (HR), and systolic blood pressure (SBP) were used to calculate RI using (HR×[age/10]2)/SBP. We used the prediction tool to predict mortality over 12 months. Results The C‐index of the admission RI for predicting in‐hospital, 1‐, 6‐, and 12‐months mortality were 0.78, 0.78, 0.78, and 0.77, respectively, compared with 0.75 of the Global Registry in Acute Coronary Events score. Based on the receiver operating characteristic curve analysis, the RI was categorized into quintiles for convenient clinical use, and it revealed a nearly 15‐fold gradient of increasing mortality from 2.29 to 32.5% (p < .0001) while RI >34 had the highest mortality. By categorizing into five different risk groups, the short‐term and long‐term mortality of patients receiving different treatments could be distinguished. Conclusions RI based on three routine variables and easily calculated by any medical practitioner is useful for predicting in‐hospital and long‐term mortality in patients with STEMI at the initial consultation with clinicians.

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Section: Discussionsupporting

confidence: 59%

Section: Discussionmentioning

confidence: 99%

Evaluation of a risk index for predicting short‐term and long‐term outcomes in patients with ST‐elevation myocardial infarction

Shao

Wang

et al. 2020

Cathet Cardio Intervent

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“…A report only recently available from Chinese investigators indicated there was no significant relationship between admission MBP and 30-day mortality in patients with STsegment elevation MI, in which primary PCI was performed in only approximately 12% of the study population. 10) In the present report concerning primary PCI-treated AMI patients, admission MBP < 79 mmHg, an extremely low MBP subset, was tightly associated with higher in-hospital mortality, where- as the other quintiles had almost similar in-hospital mortality rates. We cannot explain the discrepancy in these data; however, it is possible that the presence or absence of patients with cardiogenic shock among the study population might have contributed to these conflicting results.…”

Section: Discussionmentioning

confidence: 47%

“…8,9) However, sufficient data regarding the effects of the steady component of blood pressure, MBP, at admission on the prognosis in AMI patients are still lacking. 10) The AMI-Kyoto Multi-Center Risk Study, a large multicenter observational study in which collaborating hospitals in Kyoto Prefecture have collected demographic, procedural, and outcome data on AMI patients, was established in 2000 in order to analyze this data and establish an emergency-hospital network for heart diseases in Kyoto.…”

Section: B Ased On Numerous Reports From Western Countries Anmentioning

confidence: 99%

Relationship Between Mean Blood Pressure at Admission and In-Hospital Outcome After Primary Percutaneous Coronary Intervention for Acute Myocardial Infarction

et al. 2016

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SummaryA J-shaped or U-shaped curve phenomenon might exist between systolic blood pressure (SBP) or pulse pressure (PP) at admission and in-hospital mortality in Japanese patients with acute myocardial infarction (AMI) undergoing primary percutaneous coronary intervention (PCI). However, data regarding a relationship between mean blood pressure (MBP) at admission and in-hospital outcome in AMI patients undergoing primary PCI are still lacking in Japan.A total of 1,413 primary PCI-treated AMI patients were classified into quintiles based on admission MBP (< 79 n = 283, 79-91 n = 285, 92-103 n = 285, 104-115 n = 279, and ≥ 116 mmHg n = 281). Patients with MBP < 79 mmHg had a significantly higher in-hospital mortality, while mortality was not significantly different among the other quintiles: 16.6% (< 79), 4.9% (79-91), 3.9% (92-103), 3.2% (104-115), and 5.0% (≥ 116 mmHg). On multivariate analysis, Killip class ≥ 3 at admission, LMT or multivessels as culprit lesions, admission MBP < 79 mmHg, and age were independent positive predictors of in-hospital mortality, whereas hypercholesterolemia and TIMI 3 flow before/after PCI were negative predictors, while the other MBP categories were not.These results suggest that admission MBP < 79 mmHg might be associated with in-hospital death, and the in-hospital prognostic effects of MBP, the steady component of blood pressure, at admission might be different from those of SBP or PP, the pulsatile component of blood pressure, at admission in Japanese AMI patients undergoing primary PCI. (Int Heart J 2016; 57: 547-552) Key words: Systolic blood pressure, Pulse pressure, Prognosis, J-curve phenomenon B ased on numerous reports from Western countries, an inverse relationship between systolic blood pressure (SBP) at admission and in-hospital mortality in acute myocardial infarction (AMI) patients has largely been established, [1][2][3][4] and indeed admission SBP is involved in several riskscoring methods for AMI patients.5-7) In addition to major blood pressure indexes, such as SBP and diastolic blood pressure (DBP), blood pressure is characterized by its pulsatile and steady components, which correspond to pulse pressure (PP) and mean blood pressure (MBP), respectively. We have already shown that admission SBP or PP in a certain interval between an extremely low subset and extremely high subset might be associated with a lower in-hospital mortality in Japanese AMI patients undergoing primary percutaneous coronary intervention (PCI), which followed a J-or U-shaped curve pattern. 8,9) However, sufficient data regarding the effects of the steady component of blood pressure, MBP, at admission on the prognosis in AMI patients are still lacking.

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“…Limited data exist regarding the potential predictive importance of other bp indices in patients with ACS. In a recent retrospective analysis on 7033 STEMI patients, comparison of admission systolic BP, diastolic BP, pulse pressure, and mean BP showed that only systolic BP and pulse pressure were associated with 30‐day all‐cause mortality …”

Section: Admission Blood Pressure and Patient Outcome In Acute Coronamentioning

confidence: 99%

Hypertension and patients with acute coronary syndrome: Putting blood pressure levels into perspective

Κωνσταντίνου

Tsioufis

Koumelli

et al. 2019

J of Clinical Hypertension

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Arterial hypertension is a well‐established cardiovascular risk factor, and blood pressure (BP) control has largely improved the prognosis of hypertensive patients. A number of studies have assessed the role of BP levels in the prognosis of patients with acute coronary syndromes. Pathophysiologic links of hypertension to acute myocardial infarction (MI) include endothelial dysfunction, autonomic nervous system dysregulation, impaired vasoreactivity, and a genetic substrate. A history of hypertension is highly prevalent among patients presenting with MI, and some, but not all, studies have associated it with a worse prognosis. Some data support that low levels of admission and in‐hospital BP may indicate an increased risk for subsequent events. Risk scores used in patients with MI have, therefore, included BP levels and a history of hypertension in their variables. Of note, good long‐term BP control, ideally initiated prior to discharge, should be pursued in order to improve secondary prevention.

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Comparison of 4 Admission Blood Pressure Indexes for Predicting 30-Day Mortality in Patients With ST-Segment Elevation Myocardial Infarction

Abstract: Pulse pressure was an independent predictor of mortality in patients with STEMI, and low admission blood pressure should serve as a warning sign.

Cited by 20 publications

References 30 publications

Evaluation of a risk index for predicting short‐term and long‐term outcomes in patients with ST‐elevation myocardial infarction

Evaluation of a risk index for predicting short‐term and long‐term outcomes in patients with ST‐elevation myocardial infarction

Relationship Between Mean Blood Pressure at Admission and In-Hospital Outcome After Primary Percutaneous Coronary Intervention for Acute Myocardial Infarction

Hypertension and patients with acute coronary syndrome: Putting blood pressure levels into perspective

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