TY - JOUR
T1 - Impact of hypertension on mortality in patients with ST-elevation myocardial infarction undergoing primary angioplasty
T2 - insights from the international multicenter ISACS-STEMI registry
AU - De Luca, Giuseppe
AU - Nardin, Matteo
AU - Algowhary, Magdy
AU - Uguz, Berat
AU - Oliveira, Dinaldo C
AU - Ganyukov, Vladimir
AU - Zimbakov, Zan
AU - Cercek, Miha
AU - Okkels Jensen, Lisette
AU - Loh, Poay Huan
AU - Calmac, Lucian
AU - Roura I Ferrer, Gerard
AU - Quadros, Alexandre
AU - Milewski, Marek
AU - Scotto D'Uccio, Fortunato
AU - von Birgelen, Clemens
AU - Versaci, Francesco
AU - Ten Berg, Jurrien
AU - Casella, Gianni
AU - Lung, Aaron Wong Sung
AU - Kala, Petr
AU - Díez Gil, José Luis
AU - Carrillo, Xavier
AU - Dirksen, Maurits
AU - Becerra-Munoz, Victor M
AU - Lee, Michael Kang-Yin
AU - Juzar, Dafsah Arifa
AU - de Moura Joaquim, Rodrigo
AU - Paladino, Roberto
AU - Milicic, Davor
AU - Davlouros, Periklis
AU - Bakraceski, Nikola
AU - Zilio, Filippo
AU - Donazzan, Luca
AU - Kraaijeveld, Adriaan
AU - Galasso, Gennaro
AU - Lux, Arpad
AU - Marinucci, Lucia
AU - Guiducci, Vincenzo
AU - Menichelli, Maurizio
AU - Scoccia, Alessandra
AU - Yamac, Aylin Hatice
AU - Mert, Kadir Ugur
AU - Flores Rios, Xacobe
AU - Kovarnik, Tomas
AU - Kidawa, Michal
AU - Moreu, Josè
AU - Flavien, Vincent
AU - Fabris, Enrico
AU - Lozano Martínez-Luengas, Iñigo
AU - Et al.
PY - 2024/10/14
Y1 - 2024/10/14
N2 - Background: Hypertension is the most prevalent cardiovascular risk factor, with several detrimental effects on the cardiovascular system. Contrasting results have been reported so far on its prognostic role in patients admitted for ST-segment elevation myocardial infarction (STEMI). Therefore, we investigated the impact of hypertension on short-term mortality in a large multicenter contemporary registry of STEMI patients, including patients treated during COVID-19 pandemic. Methods: The ISACS-STEMI COVID-19 was a retrospective registry that included STEMI patients treated with primary percutaneous coronary intervention (PCI) between March and June of 2019 and 2020 in 109 high-volume primary PCI centers from 4 continents. We collected data on baseline, clinical and procedural characteristics, in-hospital outcome and 30-day mortality. For this analysis patients were grouped according to history of hypertension at admission. Results: A total of 16083 patients were assessed, including 8813 (54.8%) with history of hypertension. These patients were more often elderly, with a worse cardiovascular risk profile, but were less frequently active smoker. Some procedural differences were observed between the two groups, including lower rate of thrombectomy and use of glycoprotein IIb/IIIa inhibitors or cangrelor but more extensive coronary disease in patients with hypertension. Between patients with and without hypertension, there was no significant difference in SARS-CoV-2 positivity. Hypertensive patients had a significantly higher in-hospital and 30-day mortality, similarly observed in both pre-COVID-19 and COVID-19 era, and confirmed after adjustment for main baseline differences and propensity score (in-hospital mortality: adjusted odds ratio (OR) [95% confidence interval (CI)] = 1.673 [1.389-2.014], P < 0.001; 30-day mortality: adjusted hazard ratio (HR) [95% CI] = 1.418 [1.230-1.636], P < 0.001). Conclusion: This is one of the largest and contemporary study assessing the impact of hypertension in STEMI patients undergoing primary angioplasty, including also the COVID-19 pandemic period. Hypertension was independently associated with significantly higher rates of in-hospital and 30-day mortality.
AB - Background: Hypertension is the most prevalent cardiovascular risk factor, with several detrimental effects on the cardiovascular system. Contrasting results have been reported so far on its prognostic role in patients admitted for ST-segment elevation myocardial infarction (STEMI). Therefore, we investigated the impact of hypertension on short-term mortality in a large multicenter contemporary registry of STEMI patients, including patients treated during COVID-19 pandemic. Methods: The ISACS-STEMI COVID-19 was a retrospective registry that included STEMI patients treated with primary percutaneous coronary intervention (PCI) between March and June of 2019 and 2020 in 109 high-volume primary PCI centers from 4 continents. We collected data on baseline, clinical and procedural characteristics, in-hospital outcome and 30-day mortality. For this analysis patients were grouped according to history of hypertension at admission. Results: A total of 16083 patients were assessed, including 8813 (54.8%) with history of hypertension. These patients were more often elderly, with a worse cardiovascular risk profile, but were less frequently active smoker. Some procedural differences were observed between the two groups, including lower rate of thrombectomy and use of glycoprotein IIb/IIIa inhibitors or cangrelor but more extensive coronary disease in patients with hypertension. Between patients with and without hypertension, there was no significant difference in SARS-CoV-2 positivity. Hypertensive patients had a significantly higher in-hospital and 30-day mortality, similarly observed in both pre-COVID-19 and COVID-19 era, and confirmed after adjustment for main baseline differences and propensity score (in-hospital mortality: adjusted odds ratio (OR) [95% confidence interval (CI)] = 1.673 [1.389-2.014], P < 0.001; 30-day mortality: adjusted hazard ratio (HR) [95% CI] = 1.418 [1.230-1.636], P < 0.001). Conclusion: This is one of the largest and contemporary study assessing the impact of hypertension in STEMI patients undergoing primary angioplasty, including also the COVID-19 pandemic period. Hypertension was independently associated with significantly higher rates of in-hospital and 30-day mortality.
U2 - 10.1097/HJH.0000000000003890
DO - 10.1097/HJH.0000000000003890
M3 - Article
SN - 0263-6352
JO - Journal of Hypertension
JF - Journal of Hypertension
ER -