Impact of in-hospital blood pressure variability on cardiovascular outcomes in patients with acute coronary syndrome

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Abstract

To evaluate the impact of blood pressure variability (BPV) on cardiovascular outcomes in patients with acute coronary syndrome, short-term BPV was estimated by using weighted standard deviation of 24-hour ambulatory blood pressure monitoring readings. The primary outcome was in-hospital major adverse cardiac events (MACE). Overall, 200 patients (mean age, 58.6 years; 27.5% women; 38% with diabetes mellitus; and 47% smokers) were divided into low and high BPV groups based on the median value (9.45). Patients in the high BPV group were more likely to have in-hospital MACE compared with patients with low BPV (47% vs 27%, P = .003). Multivariate binary logistic regression analysis of incidence of MACE showed that BPV (odds ratio, 2.4; confidence interval, 1.2–4.5 [P = .008]) and presence of type II diabetes mellitus (odds ratio, 2.6; confidence interval, 1.2–5.3 [P = .008]) were the only independent predictors of in-hospital MACE derived mainly by hypertensive emergencies. BPV could be an important risk factor for in-hospital MACE in patients with acute coronary syndrome.

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