Impact of Elevated Admission Systolic Blood Pressure on Long-term Outcomes in Patients With Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention
10.3969/j.issn.1000-3614.2018.05.004
- VernacularTitle:入院收缩压升高对行冠状动脉介入治疗的急性冠状动脉综合征患者远期预后的影响
- Author:
Yue LIU
1
;
Yi YAO
;
Ying SONG
;
Xiao-Fang TANG
;
Na XU
;
Huan-Huan WANG
;
Jing-Jing XU
;
Ru LIU
;
Lin JIANG
;
Ping JIANG
;
Li-Jian GAO
;
Yin ZHANG
;
Lei SONG
;
Jue CHEN
;
Shu-Bin QIAO
;
Yue-Jin YANG
;
Run-Lin GAO
;
Bo XU
;
Jin-Qing YUAN
Author Information
1. 北京协和医学院 中国医学科学院 国家心血管病中心 阜外医院 心内科
- Keywords:
Acute coronary syndrome;
Systolic blood pressure;
Percutaneous coronary intervention;
Stroke
- From:
Chinese Circulation Journal
2018;33(5):429-434
- CountryChina
- Language:Chinese
-
Abstract:
Objectives: To investigate the prognostic value of elevated systolic blood pressure (SBP) at admission in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). Methods: A total of 5 826 consecutive ACS patients undergoing PCI were included. Patients were divided into normal admission SBP (100-139 mmHg, n=4 323) and elevated admission SBP ( ≥ 140 mmHg, n=1 503) groups. All-cause mortality and major adverse cardiovascular and cerebrovascular events (MACCE, including all-cause death, myocardial infarction (MI), revascularization, in-stent thrombosis and stroke) during 2-year follow-up were compared between the two groups. Cox proportional hazard regression models were used to identify the independent risk factors of outcomes. The influence of admission SBP on the outcomes of subgroup patients with unstable angina (n=4 261) was also evaluated. Results: Patients were older (61 vs 57 years, P<0.001), proportions of females (29.3% vs 21.6%, P<0.001), concomitant morbidities (such as hypertension, diabetes mellitus, hyperlipemia, previous MI and cerebral vascular disease) and multi-vessel lesions (77.5% vs 71.0%, P<0.001) were significantly higher in elevated admission SBP group than in normal admission SBP group. During two-years follow-up, all-cause mortality, MACCE, MI and revascularization rates were comparable between two groups (all P>0.05). However, incidence of in-stent thrombosis (1.3% vs 0.7%, P=0.048) and stroke (1.9% vs 1.2%, P=0.038) were significantly higher in elevated admission SBP group than in normal admission SBP group. Subgroup analysis on patients with unstable angina showed that, incidence of in-stent thrombosis and MI were also significantly higher in elevated admission SBP group than in normal admission SBP group (both P<0.05). Cox regression analysis showed that elevated admission SBP was no longer an independent predictor of either in-stent thrombosis or stroke, and age and history of cerebrovascular disease were the independent risk factors of stroke. Conclusions: ACS patients with elevated admission SBP have more cardiovascular risk factors, but elevated admission SBP is not an independent risk factor of long-term outcomes in this patient cohort.
