Produção Nacional
Revisado por pares
Impact of hypertension on mortality in patients with ST-elevation myocardial infarction undergoing primary angioplasty: insights from the international multicenter ISACS-STEMI registry
2024; Lippincott Williams & Wilkins; Linguagem: Inglês
10.1097/hjh.0000000000003890
ISSN1473-5598
AutoresGiuseppe De Luca, Matteo Nardin, Magdy Algowhary, Berat Uğuz, Dinaldo Cavalcanti de Oliveira, V. I. Ganyukov, Zan Zimbakov, Miha Čerček, Lisette Okkels Jensen, Poay Huan Loh, Lucian Câlmâc, Gerard Roura Ferrer, Alexandre Schaan de Quadros, Marek Milewski, Fortunato Scotto D’Uccio, Clemens von Birgelen, Francesco Versaci, Jurriën M. ten Berg, Gianni Casella, Aaron Wong Sung Lung, Petr Kala, José Luis Díez Gil, Xavier Carrillo, Maurits T. Dirksen, Víctor Manuel Becerra‐Muñoz, Michael Lee, Dafsah Arifa Juzar, Rodrigo de Moura Joaquim, Roberto Paladino, Davor Milicić, Periklis Davlouros, Nikola Bakraceski, Filippo Zilio, Luca Donazzan, Adriaan O. Kraaijeveld, Gennaro Galasso, Árpád Lux, Lucia Marinucci, Vincenzo Guiducci, Maurizio Menichelli, Alessandra Scoccia, Aylin Hatice Yamaç, Kadir Uğur Mert, Xacobe Flores‐Ríos, Tomáš Kovárník, Michał Kidawa, José Moreu, Flavien Vincent, Enrico Fabris, Íñigo Lozano, Marco Boccalatte, Francisco Bosa Ojeda, Carlos Arellano Serrano, Gianluca Caiazzo, Giuseppe Cirrincione, Hsien‐Li Kao, Juan Sanchís, Luigi Vignali, Hélder Pereira, Stéphane Manzo‐Silberman, Santiago Ordóñez, Alev Arat Özkan, Bruno Scheller, Heidi Lehtola, Rui Campante Teles, Christos Mantis, Ylitalo Antti, João Silveira, Rodrigo Zoni, И. С. Бессонов, Stefano Savonitto, George Kochiadakis, Dimitrios Alexopulos, C. Uribe, John Kanakakis, Benjamin Faurie, Gabriele Gabrielli, Alejandro Gutiérrez, Juan Pablo Bachini, Alex Rocha, Frankie Chor-Cheung Tam, Alfredo Rodriguez, Antonia Anna Lukito, Veauthyelau Saint-Joy, Gustavo Pessah, Guido Parodi, Mohammed Abed Burgadha, Elvin Kedhi, Pablo Lamelas, Harry Suryapranata, Monica Verdoia,
Tópico(s)COVID-19 Clinical Research Studies
ResumoBackground: 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 undergoing primary angioplasty, including also the COVID-19 pandemic period. Hypertension was independently associated with significantly higher rates of in-hospital and 30-day mortality.
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