Why the study?
The study investigated the outcomes and MACEs in AMI patients comorbid with hypertension and hyperhomocysteinemia during hospitalization and 1-year follow-up.
Does comorbidity with hypertension and hyperhomocysteinemia worsen outcomes in patients with acute myocardial infarction?
Does comorbidity with hypertension and hyperhomocysteinemia worsen outcomes in patients with acute myocardial infarction?
The combination of hypertension and hyperhomocysteinemia synergistically worsens clinical outcomes and increases MACE in patients with acute myocardial infarction.
Comorbid hypertension and hyperhomocysteinemia may identify higher-risk AMI patients; hypothesis-generating and requires prospective validation before changing practice.
This study investigated the outcomes and major adverse cardiovascular events (MACEs) incurred by acute myocardial infarction (AMI) patients comorbiding with hypertension and hyperhomocysteinemia (HHcy) during hospitalization and 1-year follow-up. 648 consecutive AMI patients were divided into four categories: (1) hypertension with Hcy ≥ 15 µmol/L; (2) hypertension with Hcy < 15 µmol/L; (3) no-hypertension with Hcy ≥ 15 µmol/L; (4) no-hypertension with Hcy < 15 µmol/L. Information taken from these case files included gender, past medical history, vital signs, laboratory examination, electrocardiogram, coronary angiography, cardiac ultrasound, and medicine treatment. The primary endpoints were duration of coronary care units (CCU) stay, duration of in-hospital stay, and MACEs during follow-up. Our data show that hypertension and HHcy have a synergistic effect in AMI patients, AMI comorbiding with hypertension and HHcy patients had more severe multi-coronary artery disease and more frequent non-culprit coronary lesions complete clogging, had a higher prevalence of pro-brain natriuretic peptide, and significant decreases in the left ventricular ejection fraction. These patients had significant increases in the duration of CCU stay and in-hospital stay, had significant increase in the rate of MACEs, had significant decreases in the survival rate during follow-up.
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Yan et al. (2021) studied this question.
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