Background

Previous studies have shown that optimal blood pressure (BP) control is necessary to outcomes in patients with acute myocardial infarction (AMI). Acute left ventricular MI is a prevalent type of AMI with poor prognosis. We aimed to analyze the associations between BP control in the first 7 days of hospitalization and long-term mortality specific to patients with isolated left ventricular MI.

Methods

A total of 3108 acute left ventricular MI patients were included in this analysis. The average BP on the first seven days of hospitalization was categorized into 10-mmHg increments. The primary and secondary outcomes were all-cause death and cardiac death, respectively. Cox models were used to assess the association of outcomes with BP during hospitalization.

Results

The median length-of-stay was 7 (IQR 6–10) days. The relationship between systolic BP (SBP) or diastolic BP (DBP) followed a U-shaped curve association with outcomes. All-cause mortality was higher in patients with lower SBP (≤90 mmHg) (adjusted hazard ratios (HRs) 7.12, 95% confidence interval (CI) 3.13–16.19; p < 0.001) and DBP (<60 mmHg) (HR 1.76, 95% CI 1.14–2.71; p = 0.011) [reference: 110 < SBP ≤120 mmHg; 70 < DBP ≤ 80 mmHg], respectively. Furthermore, primary outcome was higher in patients with higher SBP (>130 mmHg) (HR 1.51, 95% CI 1.12–2.03; p = 0.007) and DBP (>80 mmHg) (HR 1.61, 95% CI 1.20–2.18; p = 0.002), respectively.

Conclusion

Maintaining a SBP from 90 to 130 mmHg and a DBP from 60 to 80 mmHg may be beneficial to patients with acute left ventricular MI in the long run.

中文翻译：

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急性左心室心肌梗死患者住院第一周血压与长期死亡率的关系

背景

先前的研究表明，最佳血压 (BP) 控制对于急性心肌梗死 (AMI) 患者的预后是必要的。急性左心室 MI 是一种预后较差的常见 AMI 类型。我们旨在分析住院前 7 天的血压控制与孤立性左心室 MI 患者特有的长期死亡率之间的关联。

方法

该分析共纳入 3108 名急性左心室 MI 患者。住院前 7 天的平均血压分为 10 mmHg 增量。主要和次要结局分别是全因死亡和心源性死亡。Cox 模型用于评估住院期间结果与血压的关联。

结果

中位住院时间为 7 (IQR 6-10) 天。收缩压 (SBP) 或舒张压 (DBP) 之间的关系遵循与结果相关的 U 形曲线。SBP 较低（≤90 mmHg）（调整后的风险比（HRs）为 7.12，95% 置信区间（CI）为 3.13-16.19； p  < 0.001）和 DBP（<60 mmHg）（HR 为 1.76）的患者全因死亡率较高, 95% CI 1.14–2.71；p  = 0.011) [参考：110 < SBP ≤120 mmHg；70 < DBP ≤ 80 mmHg]，分别。此外，SBP (>130 mmHg) (HR 1.51, 95% CI 1.12–2.03; p  = 0.007) 和 DBP (>80 mmHg) (HR 1.61, 95% CI 1.20–2.18; p  = 0.002），分别。

结论

从长远来看，将 SBP 维持在 90 至 130 mmHg 和 DBP 维持在 60 至 80 mmHg 可能对急性左心室 MI 患者有益。