[OP.3B.06] MEAN SYSTOLIC BLOOD PRESSURE AFTER ADMISSION FOR MYOCARDIAL INFARCTION IS ASSOCIATED WITH ONE YEAR MORTALITY AMONG ELDERLY PATIENTS

2017 ◽  
Vol 35 ◽  
pp. e29
Author(s):  
B. Mouhat ◽  
C. Guenancia ◽  
M. Zeller ◽  
G. Cartigny ◽  
G. Porot ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Blood Pressure ◽  
Elderly Patients ◽  
Systolic Blood Pressure ◽  
One Year

scholarly journals Low Systolic Blood Pressure and Mortality in Elderly Patients After Acute Myocardial Infarction

2020 ◽  
Vol 9 (5) ◽  
Author(s):  
Basile Mouhat ◽  
Alain Putot ◽  
Olivier Hanon ◽  
Jean Christophe Eicher ◽  
Frédéric Chagué ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Blood Pressure ◽  
Acute Myocardial Infarction ◽  
Elderly Patients ◽  
Systolic Blood Pressure

Feasibility of hybrid telerehabilitation as component of a novel comprehensive care program after acute myocardial infarction in a one-year follow-up preliminary experience of a single center

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
E Piotrowicz ◽  
P Orzechowski ◽  
I Kowalik ◽  
R Piotrowicz
Keyword(s):  
Myocardial Infarction ◽  
Blood Pressure ◽  
Acute Myocardial Infarction ◽  
Heart Rate ◽  
Functional Capacity ◽  
Care Program ◽  
Comprehensive Care ◽  
Monitoring Center ◽  
One Year

Abstract Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): National Health Fund Background. A novel comprehensive care program after acute myocardial infarction (AMI) „KOS-zawał" was implemented in Poland. It includes acute intervention, complex revascularization, implantation of cardiovascular electronic devices (in case of indications), rehabilitation or hybrid telerehabilitation (HTR) and scheduled outpatient follow-up. HTR is a unique component of this program. The purpose of the pilot study was to evaluate a feasibility, safety and patients’ acceptance of HTR as component of a novel care program after AMI and to assess mortality in a one-year follow-up. Methods The study included 55 patients (LVEF 55.6 ± 6.8%; aged 57.5 ± 10.5 years). Patients underwent a 5-week HTR based on Nordic walking, consisting of an initial stage (1 week) conducted within an outpatient center and a basic stage (4-week) home-based telerehabilitation five times weekly. HTR was telemonitored with a device adjusted to register electrocardiogram (ECG) recording and to transmit data via mobile phone network to the monitoring center. The moments of automatic ECG registration were pre-set and coordinated with exercise training. The influence on physical capacity was assessed by comparing changes in functional capacity (METs) from the beginning and the end of HTR. Patients filled in a questionnaire in order to assess their acceptance of HTR at the end of telerehabilitation. Results HTR resulted in a significant improvement in functional capacity and workload duration in exercise test (Table). Safety: there were neither deaths nor adverse events during HTR. Patients accepted HTR, including the need for interactive everyday collaboration with the monitoring center. Prognosis all patients survived in a one-year follow-up. Conclusions Hybrid telerehabilitation is a feasible, safe form of rehabilitation, well accepted by patients. There were no deaths in a one-year follow-up. Outcomes before and after HTR Before telerehabilitation After telerehabilitation P Exercise time [s] 381.5 ± 92.0 513.7 ± 120.2 <0.001 Maximal workload [MET] 7.9 ± 1.8 10.1 ± 2.3 <0.001 Heart rate rest [bpm] 68.6 ± 12.0 66.6 ± 10.9 0.123 Heart rate max effort [bpm] 119.7 ± 15.9 131.0 ± 20.1 <0.001 SBP rest [mmHg] 115.6 ± 14.8 117.7 ± 13.8 0.295 DBP rest [mmHg] 74.3 ± 9.2 76.2 ± 7.3 0.079 SBP max effort [mm Hg] 159.5 ± 25.7 170.7 ± 25.5 0.003 DBP max effort [mm Hg] 84.5 ± 9.2 87.2 ± 9.3 0.043 SBP systolic blood pressure, DBP diastolic blood pressure.

The current treatment and predictors of outcome in elderly patients with non-ST-elevation myocardial infarction in an all comers population: the POPular Age registry

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M.E Gimbel ◽  
D.R.P.P Chan Pin Yin ◽  
R.S Hermanides ◽  
F Kauer ◽  
A.H Tavenier ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Elderly Patients ◽  
Major Bleeding ◽  
Oral Anticoagulation ◽  
Dual Antiplatelet Therapy ◽  
Bleeding Risk ◽  
Cardiovascular Death ◽  
St Elevation ◽  
One Year

Abstract Background Elderly patients form a large and growing part of the patients presenting with non-ST-elevation myocardial infarction (NSTEMI). Choosing the optimal antithrombotic treatment in these elderly patients is more complicated because they frequently have characteristics indicating both a high ischaemic and high bleeding risk. Purpose We describe the treatment of elderly patients (>75 years) admitted with NSTEMI, present the outcomes (major adverse cardiovascular events (MACE) and bleeding) and aim to find predictors for adverse events. Methods The POPular AGE registry is an investigator initiated, prospective, observational, multicentre study of patients aged 75 years or older presenting with NSTEMI. Patients were recruited between August 1st, 2016 and May 7th, 2018 at 21 sites in the Netherlands. The primary composite endpoint of MACE included cardiovascular death, non-fatal myocardial infarction and non-fatal stroke at one-year follow-up. Results A total of 757 patients were enrolled. During hospital stay 76% underwent coronary angiography, 34% percutaneous coronary intervention and 12% coronary artery bypass grafting (CABG). At discharge 78.6% received aspirin (non-users mostly because of the combination of oral anticoagulant and clopidogrel), 49.7% were treated with clopidogrel, 34.2% with ticagrelor and 29.6% were prescribed oral anticoagulation. Eighty-three percent of patients received dual antiplatelet therapy (DAPT) or dual therapy consisting of oral anticoagulation and at least one antiplatelet agent for a duration of 12 months. At one year, the primary outcome of cardiovascular death, myocardial infarction or stroke occurred in 12.3% of patients and major bleeding (BARC 3 or 5) occurred in 4.8% of the patients. The risk of MACE and major bleeding was highest during the first month and stayed high over time for MACE while the risk for major bleeding levelled off. Independent predictors for MACE were age, renal function, medical history of CABG, stroke and diabetes. The only independent predictor for major bleeding was haemoglobin level on admission. Conclusion In this all-comers registry, most elderly patients (≥75 years) with NSTEMI are treated with DAPT and undergoing coronary angiography the same way as younger NSTEMI patients from the SWEDEHEART registry. Aspirin use was lower as was the use of the more potent P2Y12 inhibitors compared to the SWEDEHEART which is very likely due to the concomitant use of oral anticoagulation in 30% of patients. The fact that ischemic risk stays constant over 1 year of follow-up, while the bleeding risk levels off after one month may suggest the need of dual antiplatelet therapy until at least one year after NSTEMI. Funding Acknowledgement Type of funding source: Private grant(s) and/or Sponsorship. Main funding source(s): AstraZeneca

Abstract 14652: Systolic Blood Pressure Trajectories and Cardiovascular Outcomes in SPRINT

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Charles A German ◽  
Tali Elfassy ◽  
Matthew J Singleton ◽  
Carlos J Rodriguez ◽  
Walter T Ambrosius ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Latent Class ◽  
Stable Group ◽  
Coronary Syndrome ◽  
Average Blood Pressure ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Over Time

Introduction: Blood pressure trajectories have been associated with cardiovascular disease (CVD) in observational studies. It is unclear whether these associations are independent of average blood pressure over time. Methods: We used data from SPRINT to identify systolic blood pressure (SBP) trajectories among a cohort of 8901 participants by incorporating SBP measures during the first 12 months of the trial post randomization. Trajectories were identified using latent class based modeling. Study outcomes included incident CVD, defined as myocardial infarction, acute coronary syndrome not resulting in myocardial infarction, stroke, acute decompensated heart failure, or death attributable to CVD, and all-cause mortality. Cox proportional hazards models were used to evaluate associations between SBP trajectories and our outcomes of interest. Results: Four distinct SBP trajectories were identified: ‘low decline’ (40%), ‘high decline’ (6%), ‘low stable’ (48%), and ‘high stable’ (5%) (Figure 1). Relative to the low decline group, the low stable group was associated with a 29% increased risk of CVD (HR: 1.29, 95%CI: 1.06-1.57) and the high stable group was associated with a 76% increased risk of all-cause mortality (HR: 1.76, 95%CI: 1.15-2.68) after baseline multivariable adjustment. Relative to the low stable group, the high stable group was associated with a 54% increased risk of all-cause mortality (HR: 1.54, 95%CI: 1.05-2.28). When adjusting for average blood pressure across the 12 month time period, there were no significant differences in outcomes. Conclusion: We identified 4 SBP trajectories using data from SPRINT and found differences in the risk of CVD and all-cause mortality after baseline adjustment. However, there were no differences in the risk of these outcomes after adjusting for average blood pressure over time. These results suggest that the pattern of blood pressure control may not be relevant as long as the target blood pressure is achieved.

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