Association of blood pressure in the first-week of hospitalization and long-term mortality in patients with acute left ventricular myocardial infarction.

Previous studies have shown that optimal blood pressure (BP) control is necessary to outcomes in patients with acute myocardial infarction (AMI). Acute left ventricular MI is a prevalent type of AMI with poor prognosis. We aimed to analyze the associations between BP control in the first 7 days of hospitalization and long-term mortality specific to patients with isolated left ventricular MI. A total of 3108 acute left ventricular MI patients were included in this analysis. The average BP on the first seven days of hospitalization was categorized into 10-mmHg increments. The primary and secondary outcomes were all-cause death and cardiac death, respectively. Cox models were used to assess the association of outcomes with BP during hospitalization. The median length-of-stay was 7 (IQR 6–10) days. The relationship between systolic BP (SBP) or diastolic BP (DBP) followed a U-shaped curve association with outcomes. All-cause mortality was higher in patients with lower SBP (≤90 mmHg) (adjusted hazard ratios (HRs) 7.12, 95% confidence interval (CI) 3.13–16.19; p < 0.001) and DBP (<60 mmHg) (HR 1.76, 95% CI 1.14–2.71; p = 0.011) [reference: 110 < SBP ≤120 mmHg; 70 < DBP ≤ 80 mmHg], respectively. Furthermore, primary outcome was higher in patients with higher SBP (>130 mmHg) (HR 1.51, 95% CI 1.12–2.03; p = 0.007) and DBP (>80 mmHg) (HR 1.61, 95% CI 1.20–2.18; p = 0.002), respectively. Maintaining a SBP from 90 to 130 mmHg and a DBP from 60 to 80 mmHg may be beneficial to patients with acute left ventricular MI in the long run. • Our study was firstly focused on acute left ventricular myocardial infarction (MI). • Mean BP in the 7 days after acute left MI were associated with long-term mortality. • Maintaining SBP (90-130 mmHg) and DBP (60-80 mmHg) in the 7 days after acute left MI may be beneficial. • Our data proposed an valuable hypothesis to better clinical outcomes in acute left ventricular MI. [ABSTRACT FROM AUTHOR]