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Impact of hypertension on infarct size in ST elevation myocardial infarction patients undergoing primary angioplasty

De Luca, Giuseppea; Parodi, Guidob; Sciagrà, Robertoc; Bellandi, Benedettab; Comito, Vincenzob; Vergara, Rubenb; Migliorini, Angelab; Valenti, Renatob; Antoniucci, Davidb

Journal of Hypertension:
doi: 10.1097/HJH.0b013e328364cbee
ORIGINAL PAPERS: Heart
Abstract

Background: Hypertension is a well known risk factor for atherosclerosis. However, data on the impact of hypertension in patients with ST-segment elevation myocardial infarction (STEMI) are inconsistent, and mainly related to studies performed in the thrombolytic era, with very few data on patients undergoing primary angioplasty. The aim of the current study was to evaluate the impact of hypertension on scintigraphic infarct size in STEMI patients undergoing primary percutaneous coronary intervention (PCI).

Method: Our population is represented by 830 STEMI patients undergoing primary PCI. Infarct size was evaluated at 30 days by technetium-99m-sestamibi.

Results: Hypertension was associated with more advanced age (P < 0.001), a larger prevalence of diabetes (P = 0.001), female sex (P < 0.001), but lower prevalence of smoking (P < 0.001) and anterior infarction (P = 0.042). No difference was observed in ischemia time, cardiogenic shock at presentation, in preprocedural thrombolysis in myocardial infarction (TIMI) flow, and collateral circulation. Hypertension did not affect the rate of postprocedural TIMI 3 flow. Hypertension did not affect infarct size [12.5% (4.1–23.8%) vs. 12.8% (4.3–24.7%), P = 0.38]. Similar results were observed in subanalyses in major high-risk subgroups. No impact of hypertension on infarct size was confirmed when the analysis was conducted according to the percentage of patients with infarct size above the median [adjusted odds ratio (95% CI) = 0.97 (0.72–1.33), P = 0.92].

Conclusion: This study shows that among STEMI patients, undergoing primary PCI hypertension does not affect scintigraphic infarct size.

Author Information

aDivision of Cardiology, ‘Maggiore della Carità’ Hospital, Eastern Piedmont University, Novara

bDivision of Cardiology, Careggi Hospital

cNuclear Medicine Unit, University of Florence, Florence, Italy

Correspondence to Giuseppe De Luca, MD, PhD, Division of Cardiology, ‘Maggiore della Carità’ Hospital, Eastern Piedmont University, Novara, Italy. Tel: +39 0321 3733141; fax: +39 0321 3733407; e-mail: giuseppe.deluca@maggioreosp.novara.it

Abbreviations: ACS, acute coronary syndrome; CAD, coronary artery disease; LV, left ventricle; SPECT, single-photon emission computer tomography; STEMI, ST-segment elevation acute myocardial infarction; TIMI, thrombolysis in myocardial infarction

Received 29 April, 2013

Revised 29 May, 2013

Accepted 3 July, 2013

© 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins