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INCREMENTAL PROGNOSTIC VALUE OF AMBULATORY BLOOD PRESSURE MONITORING FOR CARDIOVASCULAR EVENTS IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION: ALPS AMI SUBANALYSIS
A1443 JACC April 1, 2014 Volume 63, Issue 12
Prevention Incremental Prognostic Value of Ambulatory Blood Pressure Monitoring for Cardiovascular Events in Patients with Acute Myocardial Infarction: ALPS AMI Subanalysis Poster Contributions Hall C Monday, March 31, 2014, 9:45 a.m.-10:30 a.m.
Session Title: Prevention: Hypertension II Abstract Category: 21. Prevention: Hypertension Presentation Number: 1258-130 Authors: Masatoshi Minamisawa, Hirohiko Motoki, Atushi Izawa, Yuichiro Kashima, Takashi Miura, Souichiro Ebisawa, Yuji Shiba, Takeshi Tomita, Yusuke Miyashita, Jun Koyama, Uichi Ikeda, Department of Cardiovascular Medicine, Shinshu University School of Medicine, Matsumoto, Japan Background: Iodine-123 metaiodobenzylguanidine (MIBG) imaging is useful for assessing prognosis of patients with acute myocardial infarction (AMI). The autonomic nervous system influences circadian rhythm of blood pressure. We sought to examine the additive value of ambulatory blood pressure monitoring (ABPM) over MIBG imaging for prediction of cardiovascular events in patients with AMI. Methods: We enrolled 63 patients with AMI, who underwent ABPM and MIBG imaging after successful percutaneous coronary intervention (PCI). Patients were prospectively tracked for 2 years. We divided the subjects into 4 groups: dipping pattern and the delayed heart to mediastinum activity ratio (H/M)≥1.98 (n=18); dipping pattern and H/M<1.98 (n=16); non-dipping pattern and H/M≥1.98 (n=17); and non-dipping pattern and H/ M<1.98 (n=12). Event free survival rates were compared among 4 groups. Results: In our study cohort (age 66 ± 5 years, left ventricular ejection fraction 48 ± 14 %), cardiovascular events observed in 13 patients (20.6 %). In Kaplan-Meier analysis, patients with H/M<1.98 showed worse prognosis than patients with H/M≥1.98 (p=0.006). Furthermore, group with non-dipping pattern and H/M<1.98 showed significantly worse prognosis than the other groups (p=0.002). Conclusions: ABPM provided incremental prediction of cardiovascular events over MIBG imaging in patients with AMI. Non-dipping pattern was associated with high incidence of cardiovascular events after PCI.
Prevention Incremental Prognostic Value of Ambulatory Blood Pressure Monitoring for Cardiovascular Events in Patients with Acute Myocardial Infarction: ALPS AMI Subanalysis Poster Contributions Hall C Monday, March 31, 2014, 9:45 a.m.-10:30 a.m.
Session Title: Prevention: Hypertension II Abstract Category: 21. Prevention: Hypertension Presentation Number: 1258-130 Authors: Masatoshi Minamisawa, Hirohiko Motoki, Atushi Izawa, Yuichiro Kashima, Takashi Miura, Souichiro Ebisawa, Yuji Shiba, Takeshi Tomita, Yusuke Miyashita, Jun Koyama, Uichi Ikeda, Department of Cardiovascular Medicine, Shinshu University School of Medicine, Matsumoto, Japan Background: Iodine-123 metaiodobenzylguanidine (MIBG) imaging is useful for assessing prognosis of patients with acute myocardial infarction (AMI). The autonomic nervous system influences circadian rhythm of blood pressure. We sought to examine the additive value of ambulatory blood pressure monitoring (ABPM) over MIBG imaging for prediction of cardiovascular events in patients with AMI. Methods: We enrolled 63 patients with AMI, who underwent ABPM and MIBG imaging after successful percutaneous coronary intervention (PCI). Patients were prospectively tracked for 2 years. We divided the subjects into 4 groups: dipping pattern and the delayed heart to mediastinum activity ratio (H/M)≥1.98 (n=18); dipping pattern and H/M<1.98 (n=16); non-dipping pattern and H/M≥1.98 (n=17); and non-dipping pattern and H/ M<1.98 (n=12). Event free survival rates were compared among 4 groups. Results: In our study cohort (age 66 ± 5 years, left ventricular ejection fraction 48 ± 14 %), cardiovascular events observed in 13 patients (20.6 %). In Kaplan-Meier analysis, patients with H/M<1.98 showed worse prognosis than patients with H/M≥1.98 (p=0.006). Furthermore, group with non-dipping pattern and H/M<1.98 showed significantly worse prognosis than the other groups (p=0.002). Conclusions: ABPM provided incremental prediction of cardiovascular events over MIBG imaging in patients with AMI. Non-dipping pattern was associated with high incidence of cardiovascular events after PCI.