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ACUTE ST-ELEVATION MYOCARDIAL INFARCTION IN OBESE HYPERTENSIVE PATIENTS – CAN WE CONSIDER A DIFFERENT APPROACH?

2022; Lippincott Williams & Wilkins; Volume: 40; Issue: Suppl 1 Linguagem: Inglês

10.1097/01.hjh.0000836776.87725.08

1473-5598

Fabiana Duarte, Inês Maria Meneses dos Santos, Maria Inês Barrada, Luís Vicente Franco de Oliveira, C Serena, A Fontes, André Monteiro, C Machado, Raquel Dourado, Emília Santos, Nuno Pelicano, Miguel Pacheco, A Tavares, Dinis Martins,

Cardiac Imaging and Diagnostics

Several risk factors, including smoking habits, hypertension, obesity and diabetes, are negatively associated with adverse cardiovascular events. Acute ST-elevation myocardial infarction (STEMI) is a serious problem associated with a high burden of cardiac disease.To determine if obese hypertensive patients had a different clinical presentation and/or a poorer outcome, mainly related to hemorrhagic complications and major adverse cardiovascular events (MACE).Retrospective single center cohort study enrolled 121 patients with STEMI diagnosis, admitted to our intensive unit care. In-hospital hemorrhagic complications (IHHC) included intracerebral hemorrhage, resulting in hemodynamic compromise or requiring a blood transfusion were accessed. MACE was a composite endpoint of in-hospital cardiovascular death and sustained ventricular arrhythmic events.The mean age was 58.3 ± 12.7 years and 102 were male (84.3%). Thirty-six patients (29.8%) were overweight and twenty-four (19.8%) were obese. Hypertension was more prevalent in women (84.2% vs. 47.1%, respectively; p 0.003) and also diabetes (42.1% vs. 13.8%, respectively; p 0.021). Obese hypertensive patients were mainly women (52.6% vs. 27.5%; p 0.030). There were no statistically differences in other comorbidities between genders.All obese hypertensive patients were medicated for hypertension, 15 (39.5%) with one drug and 7 (18.4%) with two drugs. The mean systolic blood pressure (SBP) at presentation was 126 ± 2.3 mmHg and diastolic blood pressure was 78.5 ± 1.5 mmHg. Obese hypertensive patients had higher blood pressure values (SBP mean 136 ± 33 mmHg), but no differences in symptoms (p 0.20) or Killip-Kimball classification (p 0.93) were evident.Regarding to in-hospital hemorrhagic complications, females had a statistically significant higher risk (22.2% vs. 7.1%, p 0.045), but it was independent of other comorbidities, including hypertension, obesity or diabetes (r = 0.249; ANOVA p-value < 0.005).In the subset of obese hypertensive patients, no differences in IHHC (p 0.56) or MACE (p 0.18) were detected.Obese hypertensive patients were mainly women medicated with one drug. Despite higher blood pressure values, this group had similar outcomes, including hemorrhagic events. The authors advocate that a good control of risk factors is crucial to minimize their impact on clinical outcomes.