A high-systolic/low-diastolic blood pressure profile was associated with a 3.20 higher risk of adverse cardiovascular events in STEMI patients after primary PCI (HR 3.20, p=0.043).
Does a pre-procedural high-SBP/low-DBP profile predict a higher risk of adverse cardiovascular events in patients with STEMI undergoing primary PCI?
A simple pre-procedural blood pressure measurement identifying a high-SBP/low-DBP profile serves as a valuable early risk stratification tool for predicting 1-year adverse cardiovascular events in STEMI patients undergoing primary PCI.
Absolute Event Rate: 0% vs 0%
Elevated systolic blood pressure (SBP) increases myocardial oxygen demand, whereas low diastolic blood pressure (DBP) can impair coronary perfusion. The prognostic impact of this high-SBP/low-DBP (HSLD) profile in patients with ST-elevation myocardial infarction (STEMI) remains unknown. We analyzed 696 consecutive patients with STEMI undergoing primary percutaneous coronary intervention (PCI) from a prospective 11-center registry in Japan. Patients were categorized based on pre-procedural SBP (≥ 120 mmHg) and DBP (< 70 mmHg) into four groups: high-SBP/low-DBP (HSLD) high-SBP/high-DBP (HSHD), low-SBP/high-DBP (LSHD), and low-SBP/low-DBP (LSLD). The primary endpoint was a 1-year composite of cardiovascular death, non-fatal myocardial infarction, or stroke. Median follow-up was 369 days. The 1-year cumulative incidence of the primary endpoint was 7 (9.5%) in the HSLD group, 19 (4.2%) in the HSHD group, 2 (2.8%) in the LSHD group, and 5 (6.0%) in the LSLD group (log-rank p = 0.007). In multivariable Cox regression, the HSLD was independently associated with the primary endpoint compared to the HSHD group (hazard ratio 3.20, 95% CI 1.04-9.87; p = 0.043). The prognostic value of HSLD was consistent across major subgroups. A pre-procedural blood pressure pattern of SBP ≥ 120 mmHg combined with DBP < 70 mmHg independently predicts a higher risk of adverse cardiovascular events at 1 year in patients with STEMI. This simple measurement at admission identifies a previously unrecognized high-risk phenotype and presents a valuable opportunity for early risk stratification.
Muangsillapasart et al. (Mon,) reported a other. A high-systolic/low-diastolic blood pressure profile was associated with a 3.20 higher risk of adverse cardiovascular events in STEMI patients after primary PCI (HR 3.20, p=0.043).