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Impact of hypertension on mortality in patients with ST-elevation myocardial infarction undergoing primary angioplasty: insights from the international multicenter ISACS-STEMI registry
G. De Luca, M. Nardin, M. Algowhary, B. Uguz, DC. Oliveira, V. Ganyukov, Z. Zimbakov, M. Cercek, L. Okkels Jensen, PH. Loh, L. Calmac, G. Roura I Ferrer, A. Quadros, M. Milewski, F. Scotto D'Uccio, C. von Birgelen, F. Versaci, J. Ten Berg, G....
Language English Country Netherlands
Document type Journal Article, Multicenter Study
- MeSH
- COVID-19 * complications mortality MeSH
- Hypertension * complications mortality MeSH
- ST Elevation Myocardial Infarction * mortality complications therapy MeSH
- Percutaneous Coronary Intervention * MeSH
- Middle Aged MeSH
- Humans MeSH
- Hospital Mortality MeSH
- Registries * MeSH
- Retrospective Studies MeSH
- Risk Factors MeSH
- SARS-CoV-2 MeSH
- Aged MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
BACKGROUND: 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.
Azienda Ospedaliero Universitaria Ospedali Riuniti Trieste Italy
Azienda Ospedaliero Universitaria Sassari Italy
Cardiology Division Department of Internal Medicine National Taiwan University Hospital Tapei Taiwan
Cardiology Institute Istanbul University Istanbul Turkey
Carlos E Uribe Division of Cardiology Universidad UPB Universidad CES Medellin Colombia
Center for Cardiovascular Diseases Ohrid North Macedonia
Center Hospitalier d'Antibes Juan Les Pins Antibes France
Central Hospital of Medical University of Lodz Poland
Centre for Intensive Internal Medicine University Medical Centre Ljubljana Slovenia
Clinic Emergency Hospital of Bucharest Romania
Complexo Hospetaliero Universitario La Coruna La Coruna Spain
Department of Cardiology Hospital Bezmialem Vakif University İstanbul
Department of Cardiology Medisch Spectrum Twente Thoraxcentrum Twente Enschede The Netherlands
Department of Cardiology National Heart Center Singapore
Department of Cardiology National University Hospital Singapore
Department of Cardiology Queen Elizabeth Hospital University of Hong Kong Hong Kong
Department of Cardiology Queen Mary Hospital University of Hong Kong Hong Kong
Department of Cardiology University Hospital Centre University of Zagreb Zagreb Croatia
Department of Teaching and Research Instituto de Cardiología de Corrientes Juana F Cabral Argentina
Division of Cardiology Alexandra Hospital Athens Greece
Division of Cardiology Assiut University Heart Hospital Assiut University Asyut Egypt
Division of Cardiology Attikon University Hospital Athens Greece
Division of Cardiology AUSL IRCCS Reggio Emilia
Division of Cardiology Azienda Ospedaliera Ospedali Riuniti Marche Nord Pesaro
Division of cardiology Blida University Hospital Blida Algeria
Division of Cardiology Bursa City Hospital Bursa Turkey
Division of Cardiology Center Hospitalier Universitaire de Lille Lille France
Division of Cardiology CHU Lariboisière AP HP Paris 7 University INSERM UMRS 942 France
Division of Cardiology Clinica Villa dei Fiori Acerra Italy
Division of Cardiology ComplejoHospitalario de Toledo Toledo Spa in
Division of Cardiology Eskisehir Osmangazi University Faculty of Medicine Eskisehir Turkey
Division of Cardiology Groupe Hospitalier Mutualiste de Grenoble France
Division of Cardiology Heart Centre Turku Finland
Division of Cardiology Hopital Erasmus Universitè Libre de Bruxelles
Division of Cardiology Hospiatl Cordoba Cordoba Argentina
Division of Cardiology Hospital Cabueñes Gijon Spain
Division of Cardiology Hospital Clinico Universitario de Valencia Spain
Division of Cardiology Hospital de Santa Cruz CHLO Nova Medical School CEDOC Lisbon Portugal
Division of Cardiology Hospital de Santo António Porto Portugal
Division of Cardiology Hospital Puerta de Hierro Majadahonda Spain
Division of Cardiology Hospital Puerta del Mar Cadiz Spain
Division of cardiology Hospital Universitario de Canarias Santa Cruz de Tenerife
Division of Cardiology Konstantopoulion Hospital Athens Greece
Division of Cardiology Medical University of Silezia Katowice Poland
Division of Cardiology Northwest Clinics Alkmaar The Netherlands
Division of Cardiology Odense Universitets Hospital Odense Denmark
Division of Cardiology Ospedale A Manzoni Lecco Italy
Division of Cardiology Ospedale Civico Arnas Palermo Italy
Division of Cardiology Ospedale degli Infermi ASL Biella Italy
Division of Cardiology Ospedale F Spaziani Frosinone
Division of Cardiology Ospedale G Moscati Aversa
Division of Cardiology Ospedale Maggiore Bologna Italy
Division of Cardiology Ospedale S Giovanni Bosco Napoli Italy
Division of Cardiology Ospedale S Maurizio Bolzano Italy
Division of Cardiology Ospedale San Giovanni di Dio e Ruggi d'Aragona Salerno Italy
Division of Cardiology Ospedale Sant'Anna Ferrara Italy
Division of Cardiology Ospedale Santa Chiara di Trento
Division of Cardiology Ospedale Santa Maria delle Grazie Pozzuoli Italy
Division of Cardiology Ospedale Santa Maria Goretti Latina Italy
Division of Cardiology Otamendi Hospital Buenos Aires Argentina
Division of Cardiology Oulu University Hospital Finland
Division of Cardiology Radboud University Medical Center Nijmegen The Netherlands
Division of Cardiology St Antonius Hospital Nieuwegein The Netherlands
Division of Cardiology UMC Utrecht The Netherlands
H Universitario y Politécnico La Fe Valencia Spain
Heraklion University Hospital Crete Greece
Hospital Clínico Universitario Virgen de la Victoria Málaga Spain
Hospital Garcia de Orta Cardiology Department Pragal Almada Portugal
Hospital Germans Triasi Pujol Badalona Spain
Instituto Cardiovascular de Buenos Aires Buenos Aires Argentina
Instituto de Cardiologia de Santa Catarina Praia Comprida São José Brazil
Instituto de Cardiologia do Rio Grande do Sul Porto Alegre
Instituto de Cardiologia Integral Montevideo Uruguay
Internal Medicine Department of Medicine ASST Spedali Civili Brescia Italy
Interventional Cardiolgy Unit IRCCS INRCA Ancona Italy
Interventional Cardiology Unit Azienda Ospedaliera Sanitaria Parma Italy
Interventional Cardiology Unit Heart Disease Institute Hospital Universitari de Bellvitge Spain
Invasive Cardiology and Congenital Heart Disease Patras University Hospital Patras Greece
Maastricht University Medical Center The Netherlands
Tyumen Cardiology Research Center Russia
University Hospital Brno Medical Faculty of Masaryk University Brno Czech Republic
References provided by Crossref.org
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- $a Impact of hypertension on mortality in patients with ST-elevation myocardial infarction undergoing primary angioplasty: insights from the international multicenter ISACS-STEMI registry / $c G. De Luca, M. Nardin, M. Algowhary, B. Uguz, DC. Oliveira, V. Ganyukov, Z. Zimbakov, M. Cercek, L. Okkels Jensen, PH. Loh, L. Calmac, G. Roura I Ferrer, A. Quadros, M. Milewski, F. Scotto D'Uccio, C. von Birgelen, F. Versaci, J. Ten Berg, G. Casella, AWS. Lung, P. Kala, JL. Díez Gil, X. Carrillo, M. Dirksen, VM. Becerra-Munoz, MK. Lee, DA. Juzar, R. Moura Joaquim, R. Paladino, D. Milicic, P. Davlouros, N. Bakraceski, F. Zilio, L. Donazzan, A. Kraaijeveld, G. Galasso, A. Lux, L. Marinucci, V. Guiducci, M. Menichelli, A. Scoccia, AH. Yamac, KU. Mert, X. Flores Rios, T. Kovarnik, M. Kidawa, J. Moreu, V. Flavien, E. Fabris, I. Lozano Martínez-Luengas, M. Boccalatte, F. Bosa Ojeda, C. Arellano-Serrano, G. Caiazzo, G. Cirrincione, HL. Kao, J. Sanchis Forés, L. Vignali, H. Pereira, S. Manzo, S. Ordoñez, A. Arat Özkan, B. Scheller, H. Lehtola, R. Teles, C. Mantis, Y. Antti, JA. Brum Silveira, R. Zoni, I. Bessonov, S. Savonitto, G. Kochiadakis, D. Alexopulos, CE. Uribe, J. Kanakakis, B. Faurie, G. Gabrielli, A. Gutierrez Barrios, JP. Bachini, A. Rocha, FC. Tam, A. Rodriguez, AA. Lukito, V. Saint-Joy, G. Pessah, G. Parodi, MA. Burgadha, E. Kedhi, P. Lamelas, H. Suryapranata, M. Verdoia
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- $a BACKGROUND: 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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