Does Hypertension Associated to St Elevation Myocardial Infarction Population Modify the Expected Evolution?

Objective: To characterize the impact of hypertension on a ST elevation myocardial infarction (STEMI) population. We studied both suclinical and clinical changes Results: We reviewed the 2018 data from a geographical region of a national STEMI registry We analized 3800 patients admitted with STEMI in the primary PCI network hospitals. We interogated the national STEMI registry. The in-hospital data were analyzed. We selected the patients with history of hypertension at the moment of acute coronary syndrome diagnosis. Among those 3800 patients analyzed, 2708 (70.9%) had diagnosis of hypertension prior to STEMI. The hypertensive STEMI patients had extensive coronary involvement (31.6 vs. 11.6%, p < 0.005 multivessel disease). Among cardiovascular risk factors, the incidence of diabetes mellitus (DM) was three times higher in the hypertensive group (31.2 vs. 11.6%, p < 0.005); renal impairment and lower hemoglobin levels were noted in this group. The clinical picture at admission in the hypertensive cohort was less severe, with less acute heart failure (class Killip 3 and 4) (9.3 vs. 13.6%, p < 0.005) and lower death rate (5.9 vs.7.7%, p < 0.044). The overall death rate in our cohort was 6.9%, similar with the vast majority of other european cohorts. Conclusions: Though more severe in terms of multiple vesell involvement and cardiac risk factors, the evolution of the hypertensive patients was better probably due to the antihypertensive previous treatment