There is little information on the incidence and prognostic significance of arterial hypertension (HTN) in acute coronary syndromes (ACSs), especially in the east European countries. We sought to investigate a registry of ACS patients in Romania, in order to better elucidate whether hypertensive patients are at higher risk of death and deserve a tailored approach for management and follow-up. The data of this study are a framework of the International Survey of Acute Coronary Syndromes in Transitional Countries (ISACS-TC) (ClinicalTrials.gov, NCT01218776). The present analysis focused on 2286 retrospective patients admitted to 23 hospitals in Romania with a diagnosis of ACS. Among 1450 hypertensive patients, 64.5% were admitted with a diagnosis of ST elevation myocardial infarction (STEMI), while the remaining was admitted with a diagnosis of non-STEMI (NSTEMI). When compared with non-hypertensive patients, hypertensive patients were older (mean age 60.3 vs. 66.7 years, P < 0.001), were prevalently female (25.8% vs. 35.5%, P < 0.001), and had higher rates of cardiovascular risk factors as well as higher rates of prior myocardial infarction (11.2% vs. 18.3%, P < 0.001). Additionally, they had higher rates of prior stroke (4.2% vs. 11.7%, P < 0.001) and chronic heart failure (11.5% vs. 18.4%, P < 0.001). Despite this adverse clinical profile, hypertensive patients were less likely be to be admitted with Killip class ≥2 (23.1% vs. 26.6%, P < 0.001) but they were more likely to be discharged with NYHA class ≥III (10.6% vs. 7.1%, P < 0.006). There were significant higher rates of unadjusted in-hospital mortality among hypertensive older (>65 years) patients with both STEMI and NSTEMI. Hypertensive ACS patients in Romania represent a higher risk group, since they are more often discharged with NYHA class ≥ III, are older and have an adverse clinical profile. In the elderly, the outcomes of the hypertensive patients are worse than non-hypertensive patients.
Hypertension and acute coronary syndromes in Romania: data from the ISACS-TC registry / M. Dorobantu;O.-F. Tautu;A. Fruntelata;L. Calmac;G. Tatu-Chitoiu;V. Bataila;D. Dimulescu;E. Craiu;T. Nanea;A. Istvan;K. Babes;C. Macarie;C. Militaru;E. Cenko;O. Manfrini. - In: EUROPEAN HEART JOURNAL SUPPLEMENTS. - ISSN 1520-765X. - ELETTRONICO. - 16:(2014), pp. A20-A27. [10.1093/eurheartj/sut006]
Hypertension and acute coronary syndromes in Romania: data from the ISACS-TC registry
CENKO, EDINA;MANFRINI, OLIVIA
2014
Abstract
There is little information on the incidence and prognostic significance of arterial hypertension (HTN) in acute coronary syndromes (ACSs), especially in the east European countries. We sought to investigate a registry of ACS patients in Romania, in order to better elucidate whether hypertensive patients are at higher risk of death and deserve a tailored approach for management and follow-up. The data of this study are a framework of the International Survey of Acute Coronary Syndromes in Transitional Countries (ISACS-TC) (ClinicalTrials.gov, NCT01218776). The present analysis focused on 2286 retrospective patients admitted to 23 hospitals in Romania with a diagnosis of ACS. Among 1450 hypertensive patients, 64.5% were admitted with a diagnosis of ST elevation myocardial infarction (STEMI), while the remaining was admitted with a diagnosis of non-STEMI (NSTEMI). When compared with non-hypertensive patients, hypertensive patients were older (mean age 60.3 vs. 66.7 years, P < 0.001), were prevalently female (25.8% vs. 35.5%, P < 0.001), and had higher rates of cardiovascular risk factors as well as higher rates of prior myocardial infarction (11.2% vs. 18.3%, P < 0.001). Additionally, they had higher rates of prior stroke (4.2% vs. 11.7%, P < 0.001) and chronic heart failure (11.5% vs. 18.4%, P < 0.001). Despite this adverse clinical profile, hypertensive patients were less likely be to be admitted with Killip class ≥2 (23.1% vs. 26.6%, P < 0.001) but they were more likely to be discharged with NYHA class ≥III (10.6% vs. 7.1%, P < 0.006). There were significant higher rates of unadjusted in-hospital mortality among hypertensive older (>65 years) patients with both STEMI and NSTEMI. Hypertensive ACS patients in Romania represent a higher risk group, since they are more often discharged with NYHA class ≥ III, are older and have an adverse clinical profile. In the elderly, the outcomes of the hypertensive patients are worse than non-hypertensive patients.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
