engleski

Can we know the outcome in hypertensive patients with acute myocardial infarction on admission?

Objective: To examine the differences in the frequency of risk factors, clinical presentations on admission and in-hospital outcome in hypertensive and normotensive patients treated for acute myocardial infarction (AMI). Methods: In hypertensive and normotensive patients with AMI we retrospectively analyzed risk factors (age, gender, smoking habits, diabetes, blood lipids, history of angina pectoris, previous myocardial infarction, previous stroke and family history of atherothrombotic disease), clinical presentations on admission according to Killip classification and in-hospital outcome. For group comparisons we used Student's t-test and &#967; &sup2 ; test. Values of p<0.05 were considered significant. Results: Out of 396 consecutive patients with AMI, 80 (20.2%) patients died, mostly the women (32.7% vs. 12.9% for men ; p<0, 001). 187 patients were hypertensive (47.2%). Women presented more frequently with hypertension (55.1% vs. 44.9% for men ; p=0.016). In the univariate analysis hypertensive patients had less frequently presence with smoking habits (16.6% vs. 26.8% ; p=0.014) and previous myocardial infarction (2.1% vs. 7.7% ; p=0.012). Normotensive patients had less frequently history of angina pectoris (12.0% vs. 21.4% ; p=0, 021).We did not found statistically significant differences in presence of other risk factors or in Killip classification. In-hospital mortality was significantly higher in normotensive patients (24.9% vs. 15.0% ; p=0.014), regardless of gender (16.8% vs. 7.5% for men, p=0.031 ; 42.4% vs. 24.7% for women, p=0.031). Conclusion: Unexpectedly, the univariate analysis shown that hypertensive patients with AMI have better in-hospital outcome then normotensive patients. It is not sufficient to analyze risk factors and clinical presentations on admission of patients with AMI to accurately predict the early outcome.

acute myocardial infarction; risk factors; hypertension; outcome

nije evidentirano