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Journal of Cardiovascular Magnetic Resonance

, 18:80

First Online: 11 November 2016Received: 05 July 2016Accepted: 27 October 2016

Abstract

BackgroundAntecedent hypertension is associated with poor outcome in patients with ST-elevation myocardial infarction STEMI. Whether differences in myocardial salvage, infarct size and microvascular injury contribute to the adverse outcome is unknown. We investigated the association between antecedent hypertension and cardiovascular magnetic resonance CMR parameters of myocardial salvage and damage in a multicenter CMR substudy of the AIDA-STEMI trial Abciximab Intracoronary versus intravenously Drug Application in ST-elevation myocardial infarction.

MethodsWe analyzed 792 consecutive STEMI patients reperfused within 12 h after symptom onset. Patients underwent CMR imaging for assessment of myocardial salvage, infarct size and microvascular obstruction within 10 days after infarction. Major adverse cardiac events MACE were recorded at 12-month follow-up.

ResultsAntecedent hypertension was present in 540 patients 68 % and was associated with a significantly increased baseline risk profile advanced age, higher body mass index, higher incidence of diabetes, hypercholesterolemia, previous angioplasty and multivessel disease, p < 0.001 for all. MACE were more frequent in patients with hypertension as compared to patients without hypertension 45 8 % vs. 8 3 %, p < 0.01. Antecedent hypertension remained an independent predictor of MACE after multivariate adjustment hazard ratio 3.42 confidence interval 1.45–8.08, p < 0.01. There was, however, no significant difference in the area at risk, infarct size, myocardial salvage index, extent of microvascular obstruction, and left ventricular ejection fraction between the groups all p > 0.05.

ConclusionDespite a higher rate of MACE in contemporary reperfused STEMI patients with antecedent hypertension, there was no difference in reperfusion efficacy, infarct size and reperfusion injury as visualized by CMR.

Trial registrationNCT00712101.

KeywordsHypertension ST-elevation myocardial infarction Cardiovascular magnetic resonance Major adverse cardiac events AbbreviationsAIDA-STEMIAbciximab Intracoronary versus intravenously Drug Application in ST-elevation myocardial infarction

CMRCardiovascular magnetic resonance

HTNArterial hypertension

LVLeft ventricular

MACEMajor adverse cardiac events

MIMyocardial infarction

PPCIPrimary percutaneous coronary intervention

STEMIST-elevation myocardial infarction

VALIANTValsartan in Myocardial Infarction Trial

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Author: Sebastian J. Reinstadler - Thomas Stiermaier - Charlotte Eitel - Mohammed Saad - Bernhard Metzler - Suzanne de Waha - Georg

Source: https://link.springer.com/article/10.1186/s12968-016-0299-1







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