Abstract
Objective The objective of our study was to evaluate the incidence of target organ damages (TOD) in patients with arterial hypertension and the first ever episode of myocardial infarction (N-STEMI or STEMI) and to determine which of the analyzed kinds of TOD had the highest predictive value for the assessment of the likelihood of acute coronary syndrome (ACS). Material and Methods. The study group consisted of 51 patients with treated systemic hypertension, suffering from the first episode of myocardial infarction (N-STEMI or STEMI), confirmed by coronary angiography and elevation of troponin. The control group consisted of 30 subjects with treated hypertension and no history of myocardial ischaemia. In all subjects' measurements of blood lipids, hsCRP and eGFR were measured. TOD, such as intima-media thickness (IMT), presence of atherosclerotic plaques, ankle-brachial index (ABI), and left ventricular hypertrophy, were assessed. Results Age, BMI, blood pressure, and time since diagnosis of hypertension did not differ between the study groups. There were no differences regarding blood lipids and eGFR, while hsCRP was significantly increased in the study group. The left ventricular mass index was similar in both groups. Patients with myocardial infarction had significantly increased IMT and decreased ABI. The statistical analysis revealed that only ABI was the most significant predictor of ACS in the study group. Conclusion Among several TOD, ABI seems to be the most valuable parameter in the prediction of ACS.
Highlights
Arterial hypertension is one of the most important modifiable risk factors for cardiovascular complications [1]
target organ damage (TOD) such as left ventricular hypertrophy (LVH), atherosclerotic plaque, carotid intima-media thickness (IMT), ankle-brachial index (ABI), pulse wave velocity (PWV), and renal injury features are the best determinants of the condition of the cardiovascular system [3]
Organ-related complications of arterial hypertension included in the global cardiovascular risk assessment, i.e., left ventricular hypertrophy, carotid intima-media thickness, ankle-brachial index, and renal injury features, are taken into account as equivalent to one another
Summary
Arterial hypertension is one of the most important modifiable risk factors for cardiovascular complications [1]. We often find that the extent of cardiovascular damage implies that the actual duration of arterial hypertension is longer than that declared by the patient, possibly due to the long-term asymptomatic course of the disease as well as the cooccurrence of other risk factors for cardiovascular diseases. TOD such as left ventricular hypertrophy (LVH), atherosclerotic plaque, carotid intima-media thickness (IMT), ankle-brachial index (ABI), pulse wave velocity (PWV), and renal injury features are the best determinants of the condition of the cardiovascular system [3]. In the ESC/ESH guidelines, each TOD has equivalent weight, meaning that slight thickening of the intima-media complex has the same score as advanced left ventricular hypertrophy or hemodynamically significant stenosis within the carotid or lower limb arteries [1].
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