Table 1
Demographic and baseline characteristics of the patients by mean systolic blood pressure categories.
| PARAMETER | TOTAL (n = 1025) | MEAN SYSTOLIC BP, MM HG | P-VALUE | ||||
|---|---|---|---|---|---|---|---|
| SBP <100 (n = 88) | 100 ≤SBP <120 (n = 224) | 120 ≤SBP <140 (n = 333) | 140 ≤ SBP <160 (n = 217) | SBP ≥160 (n = 163) | |||
| Men, n (%) | 782 (76) | 73 (83) | 180 (80) | 249 (75) | 163 (75) | 117 (72) | 0.157 |
| Transferred from other hospital, n (%) | 334 (33) | 35 (40) | 76 (34) | 118 (35) | 65 (30) | 40 (25) | 0.062 |
| Drug treatment by other hospital, n (%) | 223 (22) | 19 (22) | 50 (22) | 84 (25) | 46 (21) | 24 (15) | 0.127 |
| Age, Median (Q1,Q3) | 64 (56, 71) | 63.5 (58, 70) | 64 (55.75, 70) | 64 (55, 71) | 66 (56, 72) | 63 (54.5, 72) | 0.683 |
| HR, Median (Q1,Q3)), beats/min | 75 (65, 87) | 64.5 (47.75, 75.25) | 70 (60, 82) | 76 (66, 87) | 80 (70, 93) | 80 (68.5, 90) | <0.001 |
| SBP, Median (Q1,Q3) | 130 (114, 150) | 91 (86.5, 95) | 110 (105, 114) | 130 (121, 132) | 149 (144, 150) | 170 (162.5, 180) | <0.001 |
| DBP, Median (Q1,Q3) | 80 (70, 90) | 60 (50, 63) | 70 (63.75, 76.25) | 80 (70, 80) | 90 (80, 97) | 100 (90, 110) | <0.001 |
| The number of ST elevation leads greater than 3, n (%) | 582 (57) | 60 (68) | 135 (60) | 182 (55) | 118 (54) | 87 (53) | 0.105 |
| hs-cTnI, Median (Q1,Q3) | 0.51 (0.05, 4.14) | 0.61 (0.06, 4.52) | 0.34 (0.04, 5.64) | 0.73 (0.06, 5.69) | 0.69 (0.06, 3.77) | 0.27 (0.06, 2.15) | 0.115 |
| Hypertension, n (%) | 585 (57) | 37 (42) | 97 (43) | 175 (53) | 143 (66) | 133 (82) | <0.001 |
| Diabetes, n (%) | 274 (27) | 22 (25) | 52 (23) | 89 (27) | 67 (31) | 44 (27) | 0.484 |
| Smoking history, n (%) | 367 (36) | 33 (38) | 83 (37) | 114 (34) | 85 (39) | 52 (32) | 0.597 |
| Killip classification, n (%) | <0.001 | ||||||
| 1 | 766 (75) | 45 (51) | 169 (75) | 266 (80) | 168 (77) | 118 (72) | |
| 2 | 146 (14) | 11 (12) | 30 (13) | 42 (13) | 32 (15) | 31 (19) | |
| 3 | 43 (4) | 3 (3) | 9 (4) | 13 (4) | 10 (5) | 8 (5) | |
| 4 | 70 (7) | 29 (33) | 16 (7) | 12 (4) | 7 (3) | 6 (4) | |
| Time from onset of chest pain to the PCI procedure, Median (Q1,Q3) | 174 (83, 362) | 143.5 (72.5, 229.75) | 151.5 (79.75, 300) | 193 (90, 439) | 192 (95, 435) | 156(75.5, 324.5) | 0.003 |
| Hb, Median (Q1,Q3) | 137 (124.1, 147) | 134.5(122.75,146.25) | 134(123.75, 145.25) | 136 (123, 146) | 136 (125, 149) | 141 (129.5, 152) | 0.004 |
| RBC, Median (Q1,Q3) | 4.45 (4.07, 4.83) | 4.42 (4.01, 4.76) | 4.34 (4, 4.74) | 4.38 (4.01, 4.78) | 4.47 (4.1, 4.88) | 4.62 (4.34, 5) | <0.001 |
| MPV, Median (Q1,Q3) | 10.6 (9.9, 11.3) | 10.7 (9.7, 11.4) | 10.6 (9.9, 11.12) | 10.5 (9.8, 11.3) | 10.6 (10, 11.3) | 10.6 (10, 11.2) | 0.682 |
| WBC, Median (Q1,Q3) | 10.3(8.22, 12.97) | 11.91 (9.38, 15.36) | 10.54 (8.54, 13.2) | 10.19(7.92,12.55) | 9.97 (8.12, 12.72) | 9.98(7.98,12.53) | <0.001 |
| NEUT, Median (Q1,Q3) | 7.73(5.62, 10.48) | 8.97 (6.7, 12.24) | 8.07 (5.97, 10.57) | 7.72(5.47, 10.36) | 7.56 (5.56, 10.4) | 6.96 (5.38, 9.78) | 0.009 |
| PLT, Median (Q1,Q3) | 214 (177, 256) | 213 (178.5, 273) | 218 (178.75, 252) | 210 (177, 256) | 216 (177, 255) | 213 (176, 257.5) | 0.969 |
| LYM, Median (Q1,Q3) | 1.58 (1.12, 2.24) | 1.73 (1.19, 2.67) | 1.6 (1.12, 2.29) | 1.55 (1.1, 2.11) | 1.49 (1.06, 2.1) | 1.67 (1.26, 2.59) | 0.039 |
| Glucose, Median (Q1,Q3) | 7.22 (5.81, 9.88) | 7.51 (5.91, 11.26) | 7.33 (5.89, 9.83) | 7.12 (5.77, 9.61) | 7.1 (5.81, 9.11) | 7.19(5.86,10.55) | 0.671 |
| Hyperlipemia, n (%) | 125 (12) | 7 (8) | 21 (9) | 37 (11) | 37 (17) | 23 (14) | 0.065 |
| Na, Median (Q1,Q3) | 141.5 (139.1, 143.9) | 142.2 (139.2, 144.5) | 141.5 (139.3, 144.1) | 141.2 (138.7, 143.8) | 141.3 (138.9, 143.7) | 142.1 (139.8, 143.8) | 0.511 |
| K, Median (Q1,Q3) | 3.88 (3.62, 4.21) | 3.92 (3.62, 4.26) | 3.84 (3.55, 4.2) | 3.86 (3.65, 4.21) | 3.93 (3.67, 4.19) | 3.9 (3.55, 4.22) | 0.653 |
| Cardiac arrest occurred before PCI, n (%) | 30 (3) | 7 (8) | 7 (3) | 9 (3) | 5 (2) | 2 (1) | 0.081 |
| Heart failure during PCI, n (%) | 47 (5) | 3 (3) | 11 (5) | 14 (4) | 12 (6) | 7 (4) | 0.937 |
| Malignant arrhythmia during PCI, n (%) | 83 (8) | 18 (20) | 18 (8) | 26 (8) | 15 (7) | 6 (4) | 0.001 |
| Intravenous blood pressure medication before PCI, n (%) | 54 (5) | 41 (47) | 1 (0) | 0 (0) | 0 (0) | 12 (7) | <0.001 |
| Fibrinogen, Median (Q1,Q3) | 3.12 (2.73, 3.64) | 3.01 (2.67, 3.54) | 3.08 (2.73, 3.5) | 3.15 (2.69, 3.66) | 3.2 (2.81, 3.71) | 3.14 (2.71, 3.6) | 0.203 |
| Thrombus-shadow during coronary angiogram, n (%) | 720 (70) | 70 (80) | 166 (74) | 216 (65) | 155 (71) | 113 (69) | 0.039 |
| Lesion vessel number, n (%) | 0.454 | ||||||
| 1 | 112 (11) | 6 (7) | 20 (9) | 38 (11) | 31 (14) | 17 (10) | |
| 2 | 197 (19) | 21 (24) | 45 (20) | 58 (17) | 45 (21) | 28 (17) | |
| 3 | 716 (70) | 61 (69) | 159 (71) | 237 (71) | 141 (65) | 118 (72) | |
| Number of stents, n (%) | 0.749 | ||||||
| 1 | 561 (55) | 40 (45) | 131 (58) | 188 (56) | 119 (55) | 83 (51) | |
| 2 | 344 (34) | 33 (38) | 72 (32) | 107 (32) | 72 (33) | 60 (37) | |
| 3 | 90 (9) | 9 (10) | 15 (7) | 30 (9) | 19 (9) | 17 (10) | |
| 4 | 24 (2) | 5 (6) | 5 (2) | 6 (2) | 6 (3) | 2 (1) | |
| 5 | 6 (1) | 1 (1) | 1 (0) | 2 (1) | 1 (0) | 1 (1) | |
| IABP, n (%) | 48 (5) | 10 (11) | 9 (4) | 13 (4) | 8 (4) | 8 (5) | 0.041 |
| Oral blood pressure medication before PCI, n (%) | 164 (16) | 10 (11) | 35 (16) | 54 (16) | 30 (14) | 35 (21) | 0.212 |
[i] Abbreviations: CI, confidence interval; HR, heart rate; DBP, diastolic blood pressure; SBP, systolic blood pressure; hs-cTnI, high-sensitivity cardiactroponinI; Hb, Hemoglobin; RBC, red blood cell count; MPV, Mean platelet volume; WBC, white blood cell count; NEUT, neutrophil count; PLT, platelet count; LYM, lymphocyte count; PCI, percutaneous coronary intervention; IABP, intra-aortic ballon pump.
Table 2
Crude and adjusted odds ratios for mean systolic blood pressure and diastolic blood pressure categories.
| CATEGORIES | BP QUARTILES (MMHG) | NO REFLOW (N/ TOTAL) | INCIDENCE | ODDS RATIO(CI95%) | |||
|---|---|---|---|---|---|---|---|
| CRUDE | P-VALUE | ADJUSTED | P-VALUE | ||||
| Systolic blood pressure | SBP <100 | 36/88 | 0.409 | 3.35 (2.00,5.59) | <0.001 | 3.64 (1.84,7.21) | <0.001 |
| 100 ≤SBP <120 | 50/224 | 0.223 | 1.39 (0.91,2.13) | 0.127 | 1.40 (0.89,2.20) | 0.145 | |
| 120 ≤SBP <140 | 57/333 | 0.171 | ref | – | ref | – | |
| 140 ≤ SBP <160 | 54/217 | 0.249 | 1.60 (1.05,2.44) | 0.027 | 1.62 (1.03,2.54) | 0.036 | |
| SBP ≥160 | 45/163 | 0.276 | 1.85 (1.18,2.88) | 0.007 | 2.07 (1.27,3.36) | 0.003 | |
| Diastolic blood pressure | DBP <60 | 24/67 | 0.358 | 3.17 (1.78,5.56) | <0.001 | 3.28 (1.63,6.49) | <0.001 |
| 60≤ DBP <80 | 105/408 | 0.257 | 1.97 (1.39,2.80) | <0.001 | 1.87 (1.28,2.74) | 0.001 | |
| 80 ≤DBP <100 | 61/407 | 0.150 | ref | – | ref | – | |
| DBP ≥ 100 | 52/143 | 0.364 | 3.24 (2.09,5.02) | <0.001 | 3.36 (2.07,5.46) | <0.001 | |
[i] Abbreviations: CI, confidence interval; OR, odds ratio; DBP, diastolic blood pressure; SBP, systolic blood pressure.
Models adjusted for gender, age, smoking history, heart rate, the number of ST elevation leads greater than 3, hypertension, diabetes, Killip classification on admission, cardiac arrest occurred before PCI, heart failure during PCI, malignant arrhythmia during PCI, intravenous blood pressure medication before PCI, Thrombus-shadow during coronary angiogram, Lesion-vessel number, number of stents, oral blood pressure medication before PCI.
Figure 1
The associations of blood pressure with no-reflow.
A: The association between systolic blood pressure (SBP) and no-reflow;
B: The association between diastolic blood pressure (DBP) and no-reflow;
C: The association between systolic blood pressure (SBP) and no-reflow after adjusted;
D: The association between diastolic blood pressure (DBP) and no-reflow after adjusted;
Adjusted odds ratio was calculated based on the logsitic model with adjustment of gender, age, smoking history, heart rate, a number of ST elevation leads greater than 3, hypertension, diabetes, Killip classification on admission, Cardiac arrest occurred before PCI, heart failure during PCI, malignant arrhythmia during PCI, intravenous blood pressure medication before PCI, Thrombus-shadow during coronary angiogram, Lesion-vessel number, Number of stents, oral blood pressure, and medication before PCI.
The 95% confidence intervals were represented by shaded regions.
Abbreviations: CI, confidence interval; SBP, systolic blood pressure; DBP, diastolic blood pressure; OR, odds ratio. PCI, percutaneous transluminal coronary intervention.
Table 3
Adjusted odds ratios for mean systolic and diastolic blood pressure categories in sensitivity analysis.
| CATEGORIES | BP QUARTILES (MMHG) | ODDS RATIO (CI95%) | |||||
|---|---|---|---|---|---|---|---|
| MODEL1 | P-VALUE | MODEL2 | P-VALUE | MODEL3 | P-VALUE | ||
| Systolic blood pressure | SBP <100 | 3.60 (1.99, 6.53) | <0.001 | 3.79 (2.07, 6.97) | <0.001 | 3.81 (1.89, 7.70) | <0.001 |
| 100 ≤SBP <120 | 1.40 (0.89, 2.21) | 0.145 | 1.49 (0.93, 2.36) | 0.094 | 1.49 (0.93, 2.36) | 0.093 | |
| 120 ≤SBP <140 | ref | – | ref | – | ref | – | |
| 140 ≤ SBP <160 | 1.69 (1.07, 2.65) | 0.023 | 1.75 (1.11, 2.78) | 0.017 | 1.78 (1.12, 2.82) | 0.015 | |
| SBP ≥160 | 2.26 (1.39, 3.70) | 0.001 | 2.37 (1.44, 3.90) | <0.001 | 2.38 (1.44, 3.94) | <0.001 | |
| Diastolic blood pressure | DBP <60 | 3.58 (1.87, 6.79) | <0.001 | 4.05 (2.09, 7.75) | <0.001 | 3.77 (1.85, 7.58) | <0.001 |
| 60≤ DBP <80 | 1.83 (1.26, 2.69) | 0.002 | 1.84 (1.26, 2.72) | 0.002 | 1.83 (1.25, 2.71) | 0.002 | |
| 80 ≤DBP <100 | ref | – | ref | – | ref | – | |
| DBP ≥ 100 | 3.69 (2.28, 6.01) | <0.001 | 3.95 (2.41, 6.50) | <0.001 | 3.89 (2.37, 6.41) | <0.001 | |
[i] Abbreviations: CI, confidence interval; DBP, diastolic blood pressure; oR, odds ratio; SBP, systolic blood pressure.
Model 1 adjusted for gender, age, smoking history, heart rate, the number of ST elevation leads greater than 3, hscTnI, hypertension, diabetes, Killip classification on admission, cardiac arrest occurred before PC, heart failure during PCI, malignant arrhythmia during PCI, Thrombus-shadow during coronary angiogram, Lesion-vessel number, number of stents.
Model 2 adjusted for gender, age, smoking history, heart rate, number of ST elevation leads greater than 3, transferred from other hospital, drug treatment by other hospital, hscTnI, hypertension, diabetes, Killip classification on admission, time from onset of chest pain to the PCI procedure, cardiac arrest occurred before PCI, heart failure during PCI, malignant arrhythmia during PCI, Thrombus-shadow during coronary angiogram, Lesion-vessel number, number of stents, and IABP.
Model 3 adjusted for gender, age, smoking history, heart rate, number of ST elevation leads greater than 3, transferred from other hospital, Drug treatment by other hospital, hscTnI, hypertension, diabetes, Killip classification on admission, time from onset of chest pain to the PCI procedure, cardiac arrest occurred before PCI, heart failure during PCI, malignant arrhythmia during PCI, intravenous blood pressure medication before PCI, Thrombus-shadow during coronary angiogram, Lesion-vessel number, number of stents, IABP, and oral blood pressure medication before PCI.