HOSPITAL OUTCOMES OF ST- ELEVATION MYOCARDIAL INFARCTION IN PATIENTS WITH AND WITHOUT HYPERTENSION
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Abstract
Objective: To compare hospital outcomes of ST-elevation myocardial infarction (STEMI) in patients with and without
hypertension.
Material and Methods: This observational cohort study was conducted in the department of Cardiology,
Postgraduate Medical Institute, Government Lady Reading Hospital, Peshawar. A total of 569 patients with STEMI in
which 348 patients were hypertensives while 221 were normotensives, were studied from December 2009 to
December 2010. After enrolment in the study, patients were monitored for in- hospital complications of AMI.
Results: There were differences between both study groups in the prevalence of cardiovascular risk factors and
baseline parameters on admission. Number of patients with Diuretics, hyper lipidimia, tachycardia and history of
smoking were more in hypertensive group as compared to normotensive group. Complication rates were
significantly higher in the hypertensive group as compared to normotensive group. Complication rates between
hypertensive and normotensive groups were; atrial fibrillation (AF) 12.9% Vs 5.4%; P=0.002 while ventricular
tachycardia/fibrillation (VT/VF) 11.8% Vs 11.3%; P=0.420, advanced AV block 14.4% Vs 5.4; P=0.001, acute heart
failure (AHF) 18.4% Vs 10.0%; P=0.004, cardiogenic shock(CS) 13.8% Vs 6.3%; P=0.003, recurrent MI (Re-MI)
12.6% Vs 9.5%; P=0.155, acute renal failure 6.3% Vs 2.3%;P=0.019, hospital stay(days) 6.13 Vs 6.21; P=0.466 and
in-hospital death 13.5% Vs 7.2%; P=0.013 respectively.
Conclusion: Hypertensive patients with an ST- elevation Myocardial infarction (STEMI) present with a greater
prevalence of cardiovascular risk factors and have a higher rate of adverse hospital outcomes than patients without
hypertension.
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