Shlomai Gadi, Kopel Eran, Goldenberg Ilan, Grossman Ehud
Department of Internal Medicine D and Hypertension Unit, Tel-Aviv University, Tel-Aviv, Israel; The Dr. Pinchas Borenstein Talpiot Medical Leadership Program, Tel-Aviv University, Tel-Aviv, Israel.
Heart Institute and the Neufeld Cardiac Research Institute, Leviev Heart Center, The Chaim Sheba Medical Center, Tel-Hashomer, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
J Am Soc Hypertens. 2015 Feb;9(2):97-103. doi: 10.1016/j.jash.2014.11.005. Epub 2014 Dec 2.
In patients with acute coronary syndrome (ACS), the predictive potential of admission systolic blood pressure (SBP) on early and late outcomes is not entirely clear. We investigated the association between admission SBP in patients hospitalized for ACS and subsequent morbidity and mortality in a real world setting. The study population comprised 7645 ACS patients enrolled in the Acute Coronary Syndromes Israeli Survey (ACSIS) between 2002 and 2010. We analyzed the association between admission SBP, and the rates of 7-day and 1-year all-cause mortality and of 30-day major cardiovascular adverse events (MACE). Admission SBP was categorized as low (<110 mm Hg), normal (110-140 mm Hg), high (141-160 mm Hg), and very high (>160 mm Hg). Compared with patients with normal admission SBP, those with low SBP had a significantly increased hazard ratios (HRs) for 7-day and 1-year mortality, and MACE of 2.37, 1.92, and 1.51, respectively (all P < .001). In contrast, patients with very high admission SBP had significantly decreased HRs for 7-day and 1-year mortality, and MACE of 0.46, 0.65, and 0.84, respectively (P = .004, <.001, and .07, respectively). In patients with ACS, elevated admission SBP is associated with favorable early and late outcomes.
在急性冠状动脉综合征（ACS）患者中，入院时收缩压（SBP）对早期和晚期预后的预测潜力尚不完全清楚。我们在现实环境中调查了因ACS住院患者的入院SBP与随后的发病率和死亡率之间的关联。研究人群包括2002年至2010年期间纳入以色列急性冠状动脉综合征调查（ACSIS）的7645例ACS患者。我们分析了入院SBP与7天和1年全因死亡率以及30天主要心血管不良事件（MACE）发生率之间的关联。入院SBP分为低（<110 mmHg）、正常（110 - 140 mmHg）、高（141 - 160 mmHg）和非常高（>160 mmHg）。与入院SBP正常的患者相比，SBP低的患者7天和1年死亡率以及MACE的风险比（HRs）显著增加，分别为2.37、1.92和1.51（所有P <.001）。相比之下，入院SBP非常高的患者7天和1年死亡率以及MACE的HRs显著降低，分别为0.46、0.65和0.84（P分别为.004、<.001和.07）。在ACS患者中，入院SBP升高与良好的早期和晚期预后相关。
