Blood pressure variability as a prognostic factor in patients with acute myocardial infarction. Data from the ACS-BP study

K Konstantinou,S Vaina,K Tsioufis,M Mantzouranis,A Apostolos,A Koumeli,A Sakalidis,C Fragoulis,K Papelis,K Dimitriadis

doi:10.1093/eurheartj/ehad655.2322

K Konstantinou, S Vaina + Show 8 more

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https://doi.org/10.1093/eurheartj/ehad655.2322

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Abstract Background Blood pressure variability (BPV) is considered a modern cardiovascular risk factor. There are many data relating BPV to mortality, risk of stroke and target organs damage mainly in hypertensive patients. Purpose The purpose of the present study is to investigate whether BPV in patients with acute myocardial infarction (AMI) who all underwent percutaneous coronary intervention (PCI) was associated with short and and/or long-term cardiovascular mortality. Methods A total of 402 patients (67.2% male, mean age: 62.7 years, 70.1% hypertensive, 46.9% STEMI) underwent 24-ambulatory blood pressure monitoring (ABPM) during hospitalization for MI. Both during their hospitalization and in a period of 6 and 12 months, they were reviewed to assess cardiovascular mortality. BPV extracted from the ABPM recordings using the coefficient of variation (CV) of systolic (SBP) and diastolic (DBP) blood pressure. Patients were classified into 4 quartile-intervals based on CV. Results After full adjustment of data (age, sex, type of ACS, BP, Diabetes, Chronic Kidney Disease &lt;3rd stage) patients in the quartile with the highest CV of SBP (Q4 n= 92) have a higher in-hospital (OR = 2, 07, 95% CI: 1.02-2.99, p=0.001), 6-month (OR = 1.94, 95% CI: 1.22– 3.170, p&lt;0.001) and long-term (1-year follow-up) mortality (OR = 1.81, 95% CI: 1.08-2.77, p=0.03) compared to patients presenting lower BPV and classified in the corresponding quartiles (Q1-Q3, n=310). Corresponding results were obtained from the control of the CV of DBP. Conclusions In the context of patients admitted for AMI and underwent PCI, higher post-infarction BPV of both SBP and DBP expose these patients to a higher risk of short - and long-term mortality. Consequently, monitoring of BPV in patients with AMI may identify patients with potential hemodynamic instability and contribute to early clinical decision-making.

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