Impact of multivessel versus single-vessel disease on the association between low diastolic blood pressure and mortality after acute myocardial infarction with revascularization

Abstract Background Previous studies demonstrated a J-shaped relationship between low diastolic blood pressure (DBP) and adverse clinical outcomes in patients with acute myocardial infarction (AMI) that was sensitive to revascularization. We hypothesized this differs multivessel disease (MVD) those single-vessel due differing degrees of ischemic burden. Methods Among 9,983 AMI from the Korea Acute Myocardial Infarction Registry database who underwent percutaneous coronary intervention were followed up for median duration 3.2 years, average on-treatment DBP calculated at admission, discharge, every scheduled visit divided into <70 mmHg, 70–74 75–79 ≥80 mmHg. The including all-cause death, cardiovascular (CV) non-CV _hospitalization heart failure analyzed using Cox regression models adjusted covariates. Results In MVD, death (hazard ratio [HR]: 1.47; 95% confidence interval [CI]: 1.06–2.04) CV (HR: 1.59; CI: 1.02–2.46) significantly increased showing relationship. However, these findings not significant disease. On sensitivity analysis excluding subjects baseline SBP <120 an risk mmHg remained MVD. Conclusions revascularization persisted which has high These high-risk require cautious treatment. Funding Acknowledgement Type funding sources: None.