Short-Term Prognostic Importance of Ambulatory Blood Pressure Variability in Patients with Acute ST Elevation Myocardial Infarction

Abstract

Objective: Blood pressure variability (BPV) is associated with cardiovascular disease and mortality. The aim of this study was to determine whether the effect of the ambulatory BPV on prognosis in acute myocardial infarction (AMI) patients during one month follow-up. Design: Prospective study Setting: The study was carried out at Ondokuz Mayis University, Medical Faculty, Samsun, Turkey Subjects: Ninety-two consecutive patients with first ST elevation AMI (STEMI). Intervention: BPV indices were measured as a standard deviation (SD) and coefficient of variation (CV) from the 24hour ambulatory blood pressure (BP) monitoring. Main outcome measures: Evaluate BPV as a prognostic factor Results: 24-hour and daytime systolic SD and daytime CV values were significantly higher in cardiovascular event group (P<.0001 and P=.001, respectively). No difference was shown between two groups according to diastolic BP values. After adjustment for covariates including age, sex, rate of hypertension, diabetes mellitus and revascularization treatment, Cox regression analysis showed that cardiovascular events were associated with 24-hours and daytime systolic SD (HR:1.13 for 24-hours, HR:1.18 for daytime) and CV values (HR:1.17 for 24-hours, HR:1.20 for daytime). Conclusion: In our study, we found that increased systolic BPV indices obtained from 24-hour ambulatory BP monitoring were significantly and independently associated with cardiovascular event after one month follow-up in patients with STEMI.