First 48 hours systolic blood pressure measurement at the acute phase of acute myocardial infarction is associated with one-year cardiovascular mortality among elderly patients

2019 
Background Optimal blood pressure (BP) in the elderly patients after acute myocardial infarction (AMI) is still a matter of debate and systolic blood pressure (SBP) target at the acute phase remains to be determined. Purpose In a prospective observational study, we aimed to identify optimal SBP during the 48 first hours in AMI and its prognostic value for one-year cardiovascular (CV) mortality. Methods From the RICO survey database, all consecutive patients > 75 years admitted for an AMI in cardiology intensive care unit of the university hospital of Dijon from 01/02/2012 to 31/01/2015 and discharged alive were included ( n  = 814). Exclusion criteria were in-hospital death, cardiogenic shock and end-stage renal disease. The endpoints were one-year CV mortality and major adverse cardiac events (MACE). The mean SBP values over the first 48 hours following admission were recorded and analysed. mSBP cut-off value was determined by ROC curve analysis for the prediction of one-year CV mortality (125 mmHg). Patients were divided into 2 groups according to mSBP [ n  = 391) vs. ≥ 125 mmHg ( n  = 423)]. Results The median age were 82 years. Patients with mSBP  P  = 0.008]. By multivariate logistic regression analysis, mSBP  2 [OR(95% CI): 2.24(1.11–4.55)] and GRACE risk score [OR(95% CI): 1.04(1.02–1.05)]. Conclusions In our large population-based study in elderly patients with AMI, low mSBP (
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