C. Fresco et al., PROGNOSTIC VALUE OF A HISTORY OF HYPERTENSION IN 11483 PATIENTS WITH ACUTE MYOCARDIAL-INFARCTION TREATED WITH THROMBOLYSIS, Journal of hypertension, 14(6), 1996, pp. 743-750
Objective To assess the prognostic value of a history of hypertension
in patients with acute myocardial infarction (AMI) treated with thromb
olysis. Design Retrospective adjusted analysis of outcome data of pati
ents with AMI randomly allocated to treatment in a controlled study of
alteplase versus streptokinase and heparin versus no heparin. Setting
A highly representative sample (about 90%) of Italian Coronary Care U
nits. Patients Patients with (n = 3306) and without (n = 7406) a histo
ry of treated hypertension. Main outcome measures Morbidity and mortal
ity during hospital stay and the next 6 months. Results Patients with
a history of hypertension had a significantly higher mortality, both i
n hospital and during the next 6 months. The difference persisted also
after a multivariate analysis including all major prognostic factors
for in-hospital and 6-month mortality, respectively. Left ventricular
failure and recurrent ischaemic events (angina and re-infarction) were
also significantly more frequent in hypertensives both during their h
ospital stay and during follow-up study. Conclusions A history of hype
rtension is a negative independent prognostic factor after acute myoca
rdial infarction treated with thrombolysis.