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Volume 101, Issue 9, Pages 1239-1241 (1 May 2008)


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Relation Between Blood Pressure at Hospital Discharge After an Acute Coronary Syndrome and Long-Term Survival

Cheuk-Kit Wong, MDaCorresponding Author Informationemail address, Peter Herbison, MScb, Eng Wei Tang, MMeda

Received 12 October 2007; received in revised form 11 December 2007; accepted 11 December 2007. published online 06 March 2008.

There are limited data on the relation between blood pressure (BP) at hospital discharge and long-term outcomes after acute coronary syndromes. In this study, of 1,053 consecutive survivors of acute coronary syndromes (mean age 64.9 ± 12.6 years, 63% men), patients with lower diastolic BP were older, had higher Global Registry of Acute Coronary Events (GRACE) discharge risk scores, and had higher 2-year mortality. When modeled with GRACE score in predicting survival, only diastolic BP but not pulse pressure or systolic BP was significant in predicting survival up to 5 years. When cardioprotective medications and in-hospital revascularization were incorporated in the model, the independent predictors for survival included lower GRACE score, higher diastolic BP, and the use of β blockers and statins. The square term of diastolic BP was also significant, indicating a J-shaped relation. Adding diastolic BP to GRACE score tended to improve the C index for predicting 6-, 12-, and 24-month survival (p = 0.14, 0.07, and 0.09, respectively). In conclusion, this study established the independent prognostic relation between diastolic BP and survival after acute coronary syndromes.

a Department of Cardiology, Dunedin School of Medicine, University of Otago, Dunedin Public Hospital, Dunedin, New Zealand

b Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin Public Hospital, Dunedin, New Zealand.

Corresponding Author InformationCorresponding author: Tel: 643-4747980; fax: 643-4747655.

PII: S0002-9149(08)00046-5

doi:10.1016/j.amjcard.2007.12.022


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