PROGNOSTIC VALUE OF A HISTORY OF HYPERTENSION IN 11483 PATIENTS WITH ACUTE MYOCARDIAL-INFARCTION TREATED WITH THROMBOLYSIS

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.