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Prognostic impact of pulse pressure at admission on in-hospital outcome after primary percutaneous coronary intervention for acute myocardial infarction

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Abstract

Data regarding relationship between pulse pressure (PP) at admission and in-hospital outcome in patients with acute myocardial infarction (AMI) undergoing primary percutaneous coronary intervention (PCI) are still lacking. A total of 1413 primary PCI-treated AMI patients were classified into quintiles based on admission PP (<40, n = 280; 40–48, n = 276; 49–57, n = 288; 58–70, n = 288; and ≥71 mmHg, n = 281). The patients with PP < 40 mmHg tended to have higher prevalence of male, smoking, and Killip class ≥3 at admission; right coronary artery, left main trunk (LMT), or multivessels as culprit lesions; larger number of diseased vessels; lower Thrombolysis in Myocardial Infarction (TIMI) grade in the infarct-related artery before/after primary PCI; and higher value of peak creatine phosphokinase concentration. Patients with PP < 40 mmHg had highest mortality, while patients with PP 49–57 mmHg had the lowest: 11.8 % (<40), 7.2 % (40–48), 2.8 % (49–57), 5.9 % (58–70), and 6.0 % (≥71 mmHg). On multivariate analysis, Killip class ≥3 at admission, LMT or multivessels as culprit lesions, chronic kidney disease, and age were the independent positive predictors of the in-hospital mortality, whereas admission PP 49–57 mmHg, hypercholesterolemia, and TIMI 3 flow before/after PCI were the negative ones, but admission PP < 40 mmHg was not. These results suggest that admission PP 49–57 mmHg might be correlated with better in-hospital prognosis in Japanese AMI patients undergoing primary PCI.

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Authors and Affiliations

  1. Department of Cardiology, Kyoto First Red Cross Hospital, Honmachi, Higashiyama-ku, Kyoto, 605-0981, Japan

    Jun Shiraishi, Yoshio Kohno, Sho Hashimoto, Daisuke Ito, Masayoshi Kimura, Akihiro Matsui, Hirokazu Yokoi, Hidekazu Irie, Masayuki Hyogo & Takatomo Shima

  2. Department of Emergency Medicine, Kyoto First Red Cross Hospital, Honmachi, Higashiyama-ku, Kyoto, 605-0981, Japan

    Masayasu Arihara

  3. Department of Cardiovascular Medicine, Kyoto Prefectural University School of Medicine, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan

    Takahisa Sawada, Takeshi Nakamura, Satoaki Matoba, Hiroyuki Yamada, Akiyoshi Matsumuro, Takeshi Shirayama & Hiroaki Matsubara

  4. Department of Cardiology, Kyoto Second Red Cross Hospital, Kyoto, Japan

    Makoto Kitamura

  5. Department of Cardiology, Tanabe Central Hospital, Kyotanabe, Japan

    Keizo Furukawa

Authors
  1. Jun Shiraishi
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  2. Yoshio Kohno
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  3. Takahisa Sawada
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  4. Sho Hashimoto
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  5. Daisuke Ito
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  6. Masayoshi Kimura
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  7. Akihiro Matsui
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  8. Hirokazu Yokoi
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  9. Masayasu Arihara
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  10. Hidekazu Irie
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  11. Masayuki Hyogo
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  12. Takatomo Shima
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  13. Takeshi Nakamura
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  14. Satoaki Matoba
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  15. Hiroyuki Yamada
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  16. Akiyoshi Matsumuro
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  17. Takeshi Shirayama
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  18. Makoto Kitamura
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  19. Keizo Furukawa
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  20. Hiroaki Matsubara
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Corresponding author

Correspondence to Jun Shiraishi.

Additional information

On behalf of the AMI-Kyoto Multi-Center Risk Study Group. The institutions and principal investigators of AMI-Kyoto Multi-Center Risk Study Group are listed in the Appendix.

Appendix

Appendix

The following institutions and principal investigators participated in the present study as the AMI-Kyoto Multi-Center Risk Study Group. Kyoto City Hospital: Okada T, Shima M, Takamiya A, Nakajima N, Matsunaga S; Kyoto Kidugawa Hospital: Miyanaga H, Nakagawa T, Matsui H, Kunieda Y; Kyoto Second Red Cross Hospital: Fujita H, Inoue K, Matsuo A, Kimura S, Sakatani T, Isodono K, Tsubakimoto Y; Social Insurance Kyoto Hospital: Yamada C, Tanabe S, Yagi T; Tanabe Central Hospital: Kusuoka S, Takechi N, Nishizawa S; Nantan General Hospital: Tatsumi T, Keira N, Nomura T; Ayabe Municipal Hospital: Shiga K, Kohno Y, Adachi Y; Maizuru Medical Center: Harada Y, Hikosaka T, Nakagami T; Kyoto Saiseikai Hospital: Yamahara Y, Ishibashi K, Takeda M; Gakkentoshi Hospital: Sakai R, Akashi K; Kouseikai Takeda Hospital: Matsumoto K, Kinoshita N, Sawanishi T, Nakamura R; Kameoka Municipal Hospital: Matsuo R; Aiseikai Yamashina Hospital: Yamamoto T; Fukuchiyama Municipal Hospital: Nishio M, Sakamoto T; Saiseikai Shiga Hspital: Nakamura T, Nakahara Y, Kurata H, Hadase M; Omihachiman Community Medical Center: Maki K, Tatsukawa H, Zen K, Kambayashi D; Kyoto Prefectural Yosanoumi Hospital: Honsho S; Kyoto Prefectural University School of Medicine: Shiraishi H, Yamano T.

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Shiraishi, J., Kohno, Y., Sawada, T. et al. Prognostic impact of pulse pressure at admission on in-hospital outcome after primary percutaneous coronary intervention for acute myocardial infarction. Heart Vessels 28, 434–441 (2013). https://doi.org/10.1007/s00380-012-0277-y

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  • DOI: https://doi.org/10.1007/s00380-012-0277-y

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