ORIGINAL ARTICLE   

Minerva Cardiology and Angiology 2021 June;69(3):280-7

DOI: 10.23736/S2724-5683.20.05120-8

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English

The association of resting postoperative systolic, diastolic, and mean blood pressure and pulse pressure with short- and long-term mortality in patients with acute coronary syndrome undergoing primary percutaneous coronary intervention

Qian-Li ZHU ¹, Jian ZHOU ², Pei-Ren SHAN ¹ ✉, Chang-Zuan ZHOU ¹, Peng-Fei XU ¹, Wei-Jian HUANG ¹

¹ Department of Cardiology, The Key Lab of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China; ² Zhe Jiang Hospital, Hangzhou, China

BACKGROUND: Admission blood pressure was closely associated with adverse cardiac events in acute coronary syndrome (ACS) patients. However, data regarding comparison of resting postoperative systolic, diastolic, and mean blood pressure and pulse pressure with short- and long-term mortality in patients with acute coronary syndrome undergoing primary percutaneous coronary intervention (PCI) was still lacking.
METHODS: The study analyzed 1987 ACS patients undergoing primary PCI, between January 2014 and October 2018. The primary outcomes were in-hospital cardiac and long-term all-cause mortality.
RESULTS: Bar tendency chart and adjusted odds ratios showed that the resting postoperative SBP≤100 mmHg, PP≤30 mmHg and MAP≤70 mmHg have higher in-hospital cardiac (SBP: adjusted OR=9.42, 95% CI: 1.95-45.53, P<0.01; PP: adjusted OR=8.61, 95% CI: 2.53-29.30, P<0.01; MAP: adjusted OR=4.01, 95% CI: 1.61-9.98, P<0.01) and long-term all-cause mortality (SBP: adjusted HR=4.18, 95% CI: 1.43-12.23, P<0.01; PP: adjusted HR=3.71, 95% CI: 1.66-8.24, P<0.01; MAP: adjusted HR=2.54, 95% CI: 1.14-5.65, P<0.01), and the relationship between resting postoperative SBP and in-hospital cardiac or long-term all-cause mortality seemed to follow a J-shaped curve with increased event rates at low and high groups.
CONCLUSIONS: The resting postoperative SBP≤100 mmHg, PP≤30 mmHg and MAP≤70 mmHg are independent adverse prognosticators in ACS patients undergoing primary PCI, and the relationship between SBP and mortality looks like a J-shaped curve.

KEY WORDS: Acute coronary syndrome; Percutaneous coronary intervention; Blood pressure; Mortality