48. BLOOD PRESSURE ON ADMISSION CHARACTERISTIC IN PATIENT WITH ACUTE CORONARY SYNDROME

Background:
Blood pressure had been a valuable diagnostic tool in cardiovascular disease, such as acute coronary syndrome (ACS). Nevertheless, ample studies have shown that blood pressure in ACS patients had a J-curve prognosis and known as a predictor of myocardial damage. High blood pressure is believed as a sign of larger size of viable myocytes that could still compensate the extent of injury happening during ACS.

Objective:
To compare the blood pressure on admission characteristic in patients presenting with acute coronary syndrome at National Cardiovascular Center Harapan Kita (NCCHK).

Methods:
We collected medical record data of acute coronary syndrome patients in NCCHK from January to December 2020.

Results:
This study included 1383 patients, with median age of 59: 27–94, 78.1% male patients, and 70.4% had history of hypertension. ST-segment elevation myocardial infarction (STEMI) happened in 34.3% of the patient. From our analysis, it showed that patients presenting with STEMI had lower systolic blood pressure (SBP) compared to those with the diagnosis of Non-ST segment elevation myocardial infarction (NSTEMI) or unstable angina pectoris (UAP) (124: 60–255 vs 131: 63–255 vs 136: 71–236, p = 0.000). In the subset of patients with prior hypertension, SBP in STEMI patients remained lowest compared to NSTEMI and UAP patients (132: 60–255 vs 137: 63–255 vs 142: 71: 236, p = 0.000).

Conclusion:
Subjects with STEMI, considered as those with the most extensive myocardial damage, have lowest SBP on admission compared to ACS patients without ST segment elevation even in the subset population with prior hypertension.