Association of pretreatment amlodipine and outcome in patients with acute myocardial infarction undergoing primary percutaneous coronary intervention

Abstract

Objectives: The current study is a retrospective cross-sectional study that reviewed 497 patients with an ST-elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PCI). Demographic data including age, gender, history of Hypertension (HTN), diabetes mellitus, and smoking and data related to the use of Amlodipine, pic of cardiac troponin I (cardiac enzyme), ejection fraction (EF), arrhythmia at the admission, and death after PCI extracted from the previous file. The patients were divided into two groups, the first group with a history of taking amlodipine and the second group without a history of taking amlodipine. SPSS version 26 was used for data analysis. T-tests, chi-square, and Fisher's exact were used to test the relationship between variables.
 Methods: In this retrospective cross-sectional study, the medical records of 497 patients with STEMI who underwent PCI were reviewed. The data were age, gender, previous use of Amlodipine, pic of cardiac troponin I (CINI), (EF), arrhythmia at the admission, history of HTN, Diabetes mellitus and smoking, and death after PCI. Then patients were divided into two groups with (group 1) or without (group 2) a history of Amlodipine use. Student t-test, chi-square test, and the Fisher exact test were applied to investigate the associations between variables using the SPSS version 26.
 Results: Out of 497 patients included, 81.3% were males with a mean age of 58.7±12.02 years, and 22.7% had a history of taking amlodipine. Patients in group 2 showed more death and MI than group 1 (OR = 1.32 [95% CI, 1.25-1.39], P=0.002) and (OR=3.93 [95% CI, 2.24-6.87], P<0.001). There were no differences between the two groups in terms of age, sex, cTnI, EF, rate of arrhythmia, the pattern of vascular involvement, kind of vascular involvement, and occlusion location (P= 0.6, 0.9, 0.09, 0.1, 0.3, 0.28, 0.29 and 0.8, respectively).
 Conclusions: Amlodipine administered before MI significantly reduced the mortality rate after PCI compared to patients not taking amlodipine. The result can be attributed to the antioxidant effect, limiting the consequences of injury around reperfusion.