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Hypertension is associated with increased mortality in patients with ischaemic heart disease after revascularization with percutaneous coronary intervention - a report from SCAAR.

Journal article
Authors Ott Saluveer
Björn Redfors
Oskar Angerås
Christian Dworeck
Inger Haraldsson
Charlotta Ljungman
Petur Petursson
Jacob Odenstedt
Dan Ioanes
Peter Lundgren
Sebastian Völz
Truls Råmunddal
Bert Andersson
Elmir Omerovic
Niklas Bergh
Published in Blood pressure
Volume 26
Issue 3
Pages 166-173
ISSN 1651-1999
Publication year 2017
Published at
Pages 166-173
Language en
Links dx.doi.org/10.1080/08037051.2016.12...
www.ncbi.nlm.nih.gov/entrez/query.f...
Keywords Acute Coronary Syndrome, complications, mortality, physiopathology, surgery, Age Factors, Aged, Angina Pectoris, complications, mortality, physiopathology, surgery, Coronary Angiography, Coronary Artery Disease, complications, mortality, physiopathology, surgery, Female, Humans, Male, Middle Aged, Myocardial Infarction, complications, mortality, physiopathology, surgery, Percutaneous Coronary Intervention, Prognosis, Proportional Hazards Models, Prospective Studies, Registries, Risk Factors, Sex Factors, Smoking, physiopathology, Sweden, Treatment Outcome
Subject categories Clinical Medicine

Abstract

The prognostic role of hypertension on long-term survival after percutaneous coronary intervention (PCI) is limited and inconsistent. We hypothesize that hypertension increases long-term mortality after PCI.We analyzed data from SCAAR (Swedish Coronary Angiography and Angioplasty Registry) for all consecutive patients admitted coronary care units in Sweden between January 1995 and May 2013 and who underwent PCI due to ST-elevation myocardial infarction (STEMI), non-ST-elevation myocardial infarction (NSTEMI)/unstable angina (UA) or stable angina pectoris. We used Cox proportional-hazards regression for statistical modelling on complete-case data as well as on imputed data sets. We used interaction test to evaluate possible effect-modulation of hypertension on risk estimates in several pre-specified subgroups: age categories, gender, diabetes, smoking and indication for PCI (STEMI, NSTEMI/UA and stable angina).During the study period, 175,892 consecutive patients underwent coronary angiography due to STEMI, NSTEMI/UA or stable angina. 78,100 (44%) of these had hypertension. Median follow-up was 5.5 years. After adjustment for differences in patient's characteristics, hypertension was associated with increased risk for mortality (HR 1.12, 95% CI 1.09-1.15, p < .001). In subgroup analysis, risk was highest in patients less than 65 years, in smokers and in patients with STEMI. The risk was lowest in patients with stable angina (p < .001 for interaction test).Hypertension is associated with higher mortality in patients with STEMI, NSTEMI/UA or stable angina who are treated with PCI.

Page Manager: Webmaster|Last update: 9/11/2012
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