Erschienen in:
01.07.2013 | Original Article
Prognostic impact of pulse pressure at admission on in-hospital outcome after primary percutaneous coronary intervention for acute myocardial infarction
verfasst von:
Jun Shiraishi, Yoshio Kohno, Takahisa Sawada, Sho Hashimoto, Daisuke Ito, Masayoshi Kimura, Akihiro Matsui, Hirokazu Yokoi, Masayasu Arihara, Hidekazu Irie, Masayuki Hyogo, Takatomo Shima, Takeshi Nakamura, Satoaki Matoba, Hiroyuki Yamada, Akiyoshi Matsumuro, Takeshi Shirayama, Makoto Kitamura, Keizo Furukawa, Hiroaki Matsubara
Erschienen in:
Heart and Vessels
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Ausgabe 4/2013
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Abstract
Data regarding relationship between pulse pressure (PP) at admission and in-hospital outcome in patients with acute myocardial infarction (AMI) undergoing primary percutaneous coronary intervention (PCI) are still lacking. A total of 1413 primary PCI-treated AMI patients were classified into quintiles based on admission PP (<40, n = 280; 40–48, n = 276; 49–57, n = 288; 58–70, n = 288; and ≥71 mmHg, n = 281). The patients with PP < 40 mmHg tended to have higher prevalence of male, smoking, and Killip class ≥3 at admission; right coronary artery, left main trunk (LMT), or multivessels as culprit lesions; larger number of diseased vessels; lower Thrombolysis in Myocardial Infarction (TIMI) grade in the infarct-related artery before/after primary PCI; and higher value of peak creatine phosphokinase concentration. Patients with PP < 40 mmHg had highest mortality, while patients with PP 49–57 mmHg had the lowest: 11.8 % (<40), 7.2 % (40–48), 2.8 % (49–57), 5.9 % (58–70), and 6.0 % (≥71 mmHg). On multivariate analysis, Killip class ≥3 at admission, LMT or multivessels as culprit lesions, chronic kidney disease, and age were the independent positive predictors of the in-hospital mortality, whereas admission PP 49–57 mmHg, hypercholesterolemia, and TIMI 3 flow before/after PCI were the negative ones, but admission PP < 40 mmHg was not. These results suggest that admission PP 49–57 mmHg might be correlated with better in-hospital prognosis in Japanese AMI patients undergoing primary PCI.