ST 분절 상승 심근경색 환자에서 수축기 혈압의 변동성은 장기간의 심혈관 예후에 영향을 준다.

Alternative Title
Visit-to-Visit Systolic Blood Pressure Variability in Patients with ST-elevation Myocardial Infarction Predicts Long-Term Cardiovascular Outcomes
Author(s)
소문승
Alternative Author(s)
Moon-Seung Soh
Advisor
신준한
Department
일반대학원 의학과
Publisher
The Graduate School, Ajou University
Publication Year
2017-08
Language
eng
Keyword
심근경색예후혈압 변동성
Alternative Abstract
Background: Elevated visit-to-visit blood pressure variability (BPV), independent of mean BP, has been associated with cardiovascular events in a number of diseases. However, its impact after ST-elevation myocardial infarction (STEMI) has not been established. This study aimed to investigate the prognostic impact of BPV on patients after STEMI. Methods: We analyzed the data and clinical outcomes of STEMI survivors who underwent successful primary coronary intervention from 2003 to 2007. To estimate BPV, BP was measured at discharge and at 1, 3, 6, 12, 24, and 36 months-, and we calculated BPV as the intra-individual standard deviations (SDs) of systolic BP (SBP) across these measurements. We classified the patients as high and low-BPV group, and evaluated the following outcomes: occurrence of major adverse cardiovascular events (MACEs), death, recurrent myocardial infarction, and target vessel revascularization within 60 months. Results: We enrolled 343 patients (mean age: 58 ± 12 years; 276 males), and mean follow-up duration was 68 ± 34 months (median: 76 months). Mean and median SBP SDs were 13.2 and 12.3 mmHg, and patients were divided into one of the two groups based on the median (high-BPV = SD ≥12.3 mmHg, and low-BPV group = SD <12.3 mmHg). The MACE-free survival in the high-BPV group was significantly worse than that in low-BPV group (log-rank p =0.035). For the high-BPV group, the risk of a MACE significantly increased by 57% (95% confidence interval: 1.03-2.39; p =0.038). Conclusions: Visit-to-visit systolic BPV was associated with increased rates of adverse clinical outcomes in patients after STEMI. Careful assessment of BP and attempts to reduce BPV might be also important in STEMI survivors.
URI
https://dspace.ajou.ac.kr/handle/2018.oak/19955
Fulltext

Appears in Collections:
Graduate School of Ajou University > Department of Medicine > 3. Theses(Master)
Files in This Item:
There are no files associated with this item.
Export
RIS (EndNote)
XLS (Excel)
XML

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

Browse