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Impact of hypertension on mortality in patients with ST-elevation myocardial infarction undergoing primary angioplasty:insights from the international multicenter ISACS-STEMI registry

Title: Impact of hypertension on mortality in patients with ST-elevation myocardial infarction undergoing primary angioplasty:insights from the international multicenter ISACS-STEMI registry
Authors: De Luca,Giuseppe; Nardin,Matteo; Algowhary,Magdy; Uguz,Berat; Oliveira,Dinaldo C.; Ganyukov,Vladimir; Zimbakov,Zan; Cercek,Miha; Okkels Jensen,Lisette; Loh,Poay Huan; Calmac,Lucian; Roura I Ferrer,Gerard; Quadros,Alexandre; Milewski,Marek; Scotto D'Uccio,Fortunato; Von Birgelen,Clemens; Versaci,Francesco; Ten Berg,Jurrien; Casella,Gianni; Lung,Aaron Wong Sung; Kala,Petr; Díez Gil,José Luis; Carrillo,Xavier; Dirksen,Maurits; Becerra-Munoz,Victor M.; Lee,Michael Kang Yin; Juzar,Dafsah Arifa; De Moura Joaquim,Rodrigo; Paladino,Roberto; Milicic,Davor; Davlouros,Periklis; Bakraceski,Nikola; Zilio,Filippo; Donazzan,Luca; Kraaijeveld, Adriaan; Galasso,Gennaro; Lux,Arpad; Marinucci,Lucia; Guiducci,Vincenzo; Menichelli,Maurizio; Scoccia,Alessandra; Yamac,Aylin Hatice; Mert,Kadir Ugur; Flores Rios,Xacobe; Kovarnik,Tomas; Kidawa,Michal; Moreu,Josè; Flavien,Vincent; Fabris,Enrico; Lozano Martínez-Luengas,Iñigo; Boccalatte,Marco; Bosa Ojeda,Francisco; Arellano-Serrano,Carlos; Caiazzo,Gianluca; Cirrincione,Giuseppe; Kao,Hsien Li; Sanchis Forés,Juan; Vignali,Luigi; Pereira,Helder; Manzo,Stephane; Ordoñez,Santiago; Arat Özkan,Alev; Scheller,Bruno; Lehtola,Heidi; Teles,Rui; Mantis,Christos; Antti,Ylitalo; Brum Silveira,João António; Zoni,Rodrigo; Bessonov,Ivan; Savonitto,Stefano; Kochiadakis,George; Alexopulos,Dimitrios; Uribe,Carlos E.; Kanakakis,John; Faurie,Benjamin; Gabrielli,Gabriele; Gutierrez Barrios,Alejandro; Bachini,Juan Pablo; Rocha,Alex; Tam,Frankie Chor Cheung; Rodriguez,Alfredo; Lukito,Antonia Anna; Saint-Joy,Veauthyelau; Pessah,Gustavo; Parodi,Guido; Burgadha,Mohammed Abed; Kedhi,Elvin; Lamelas,Pablo; Suryapranata,Harry; Verdoia,Monica; Team Medisch; Circulatory Health
Publication Year: 2025
Subject Terms: hypertension; mortality; ST-segment elevation myocardial infarction; Taverne; Internal Medicine; Physiology; Cardiology and Cardiovascular Medicine
Description: 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 ...
Document Type: article in journal/newspaper
File Description: text/plain
Language: English
ISSN: 0263-6352
Relation: https://dspace.library.uu.nl/handle/1874/459222
Availability: https://dspace.library.uu.nl/handle/1874/459222
Rights: info:eu-repo/semantics/OpenAccess
Accession Number: edsbas.531D7B58
Database: BASE