Abstract
Background:
Blood pressure affects the clinical outcome of acute coronary syndrome (ACS) patients. However, it is not clear what level of blood pressure is beneficial to the improvement of ACS patients in emergency department. The purpose of this study is to analyze the impact of systolic blood pressure (SBP) on ACS patient’ improvement and transfer of patient from emergency department
Methods:
A total of 2667 patients who were admitted to the Emergency Department of Chest Pain Center, Fujian Provincial Hospital due to chest pain from January 1, 2017 to March 31, 2020 were included in the study. Logistic regression was used to analyze the correlation between SBP and ACS patients’ improvement in the emergency department, and the predictive effect on the disease improvement was evaluated. The study also analyzed the impact of SBP on the improvement of different subgroups of patients in the emergency department.
Results:
In total, 592 (22.20%) out of 2667 patients were improved and transferred to the general ward. Multivariate logistic regression analysis found that SBP = 120–140 mmHg (OR = 0.700; 95% CI: 0.510–0.961; P = 0.027) was an independent predictor for the decreased likelihood of improvement of ACS patients from the emergency department; SBP > 140 mmHg (OR = 1.348; 95% CI: 1.000-1.817; P = 0.049), use of clopidogrel (OR = 1.924; 95% CI: 1.247–2.971; P = 0.003), non-ST-segment elevation myocardial infarction (NSTEMI) (OR = 2.683; 95% CI: 1.645–4.375; P < 0.001) and unstable angina (OR = 23.654; 95% CI: 15.415–36.297; P < 0.001) were all independent predictors for the increased likelihood of improvement of ACS patients in the emergency department. The area under curve (AUC) of the predictive efficacy of SBP, combined with ticagrelor, NSTEMI and unstable angina (UA) was 0.814 (95% CI: 0.795–0.833, P < 0.001).
Conclusion:
The study found that SBP = 120–140 mmHg was an independent predictor for the decreased likelihood of improvement of ACS patients from the emergency department, but SBP > 140 mmHg was an independent predictor for the increased likelihood of improvement of ACS patients. This correlation may be useful for doctors to make clinical decisions for ACS patients.
Adverse Cardiac Events in Emergency Department Patients with Chest Pain Six Months after a Negative Inpatient Evaluation for Acute Coronary Syndrome
