Key result
Antecedent hypertension was associated with increased long-term mortality (OR 1.28) in patients with acute coronary syndromes treated mainly with percutaneous coronary intervention.
Why the study?
The effect of antecedent hypertension on short- and long-term mortality after ACS in the PCI era remains unclear.
Does antecedent hypertension affect in-hospital and long-term mortality in patients with acute coronary syndromes treated with percutaneous coronary intervention?
Meta-Analysis (n=64,989)
Does antecedent hypertension affect in-hospital and long-term mortality in patients with acute coronary syndromes treated with percutaneous coronary intervention?
Antecedent hypertension is associated with higher long-term mortality in ACS patients undergoing PCI, but may be protective against in-hospital mortality specifically in NSTE-ACS patients.
Antecedent hypertension may flag higher long-term mortality risk in ACS-PCI patients; leaves open effects on in-hospital mortality and need for targeted interventions.
Background Effect of antecedent hypertension on mortality after acute coronary syndromes (ACS) in the percutaneous coronary intervention (PCI) era is less clear. The aim of this meta-analysis was to assess effect of antecedent hypertension on short and long-term mortality after ACS in the coronary intervention era. Methods PubMed, Medline, EMBASE and the Cochrane library were systematically searched up to April 2023. Ten studies with total of 64, 989 of patients met the inclusion criteria. The outcomes of interest were (i) all-cause in-hospital mortality; (ii) long-term all- cause mortality. Results No significant difference was observed in in-hospital mortality between antecedent hypertension group and non-antecedent hypertension with pooled odds ratio (OR): 1.07, 95% confidence interval (CI): 0.79–1.45; I2 = 82%, the same as ST elevation myocardial infarction (STEMI) group (pooled OR: 1.01, 95% CI: 0.73– 1.39; I2 = 66%). However, result was statistically significant for non-ST elevation myocardial infarction (NSTE-ACS) patients, with pooled OR: 0.67, 95% CI: 0.55–0.82; p = 0.0001, I2 = 0%. Antecedent hypertension was related to increased long-term mortality of patients with ACS (pooled OR 1.28, 95% CI 1.16–1.40, p = 0.0001; I2 = 0%), the same as STEMI subgroups. Conclusion In PCI era antecedent hypertension was associated with higher long-term mortality in ACS patients, but no significant difference was observed in in-hospital mortality between hypertension and non- hypertension. However, for NSTE-ACS patients’ antecedent hypertension may be a protective factor related to in- hospital mortality.
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Qi et al. (2023) conducted a meta-analysis in Acute coronary syndromes (n=64,989). Antecedent hypertension vs. Non-antecedent hypertension was evaluated on Long-term all-cause mortality (OR 1.28, 95% CI 1.16-1.40, p=0.0001). Antecedent hypertension was associated with increased long-term mortality (OR 1.28) in patients with acute coronary syndromes treated mainly with percutaneous coronary intervention.
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