Affect Of Systolic Blood Pressure At Admission, On Clinical Outcomes In-hospital In Patients With Acute Myocardial Infarction

Objective: Acute myocardial infarction(AMI) is the most serious type of coronary heart disease, also which is a common disease frequently occurring disease.The occurrence of this disease is related to many factors, include hereditary factors and effect of external factors. The more risk factors exist, the more likely to get sick. The purpose of this clinical study is to demonstrate the relationship between systolic blood pressure at admission and risk factors and culprit lesions and in-hospital mortality in patients with acute myocardial infarction.Methods: A total of 242 AMI patients were classified into quintiles based on SBP at hospital admission(<100mm Hg n=48;100-119 mm Hg n=46;120-139 mm Hg n=50; 140-160 mm Hg n=45 及 > 160 mm Hg n=53). Demographic date, biochemical indicators such as blood pressure, heart rate, complication, myocardial infarction location, serum lipids, serum uric acid, C- creactive protein level, and date about cardiac function Killip class III and Killip class IV at hospital discharge, in-patients death were collected for all subjects.Results:1 The patients with SBP < 100 mm Hg tended to have higher age(70.6±11.7), the rate of previous MI(14.5%), Killip class≥3 at admission(39.4%), higher in-hospital mortality(25.7%), right coronary artery(50.4%),left main trunk(25%),or multivessels(6.5%)as culprit lesions, larger number of diseased vessels, lower Thrombolysis In Myocardial Infarction grade in the infarct-related artery before primary percutaneous coronary intervention(PCI),and higher value of peak creatine phosphokinase concentration(4439.2±7316.1)2.Patients with SBP<100mm Hg had a significantly higher mortality, while mortality was not significantly different among the other quintiles: 25.7%(<100mm Hg), 5.4%(100-119 mm Hg), 5.7%(120-139 mm Hg), 2.5%(140-160 mm Hg),and 5.6%(>160mm Hg)(P<0.001).3 On multivariate analysis, Killip class≥3 at admission, admission SBP<100mm Hg, and age were independent positive predictors of in-hospital mortality, whereas admission SBP 140-160 mm Hg and primary PCI were the negative ones, but admission SBP 100-119 mm Hg, admission SBP 120-139 mm Hg,and admission SBP >160mm Hg were not. On multivariate analysis, Killip class ≥3 at admission、age and admission SBP<100mm Hg were the independent positive predictors of in-hospital mortality.Conclusion:1 These results suggest that admission SBP 140-160 mm Hg might be correlated with better in-hospital prognosis.2 Whereas admission SBP<100mm Hg was associated with in-hospital death in Chinese patients hospitalized for AMI.3 On multivariate analysis, Killip class ≥3 at admission, age, and admission SBP<100mm Hg were the independent positive predictors of in-hospital mortality.4 Too low blood pressure is a predictor of the deaths of patients with AMI, the patients with AMI should be paid closed attentions and their blood pressure should be controlled properly, to reduce mortality and complications and improve heart function.