Zahid Mahmood, Noeman Ahmed, Anjum Iqbal, Abdul Rashid, Naveed Arshad.
Hypertensive patients are prone to have large infarcts when present with acute coronary syndrome.
Rawal Med J Jan ;45(2):257-60.

Objective: To check the significance of hypertension in causing large infarcts in acute myocardial infarction (AMI) patients of acute coronary syndrome (ACS). Methodology: This cross sectional study included 135 AMI patients of both genders presenting within four hours of chest pain/dyspnea. At presentation, ECG and initial blood samples were taken along detailed history and examination. Blood samples for diagnosis of Non ST-elevation (NSTEMI) were also taken at 8hrs. The patients were categorized into small and large infarct groups. The patients with NSTEMI and STEMI involving ST elevation in single lead group were having small cardiac infarcts while those with ST elevation in multiple leads groups were having large infarcts. A p<= 0.05 was considered statistically significant. Results: Out of 135 patients, 58(43%) were with small and 77(57%) were with large infarct. Patients with large infarct included 63(81.8%) male and 14(18.2%) female. In large infarct patients, 54 of 63 males (85.7%) and 13 of 14 females (92.85%) had history of established hypertension. There was significant association between hypertension and infarct size. The results have shown a less significance in causing large infarct with history of smoking, diabetes or family history of ischemic heart disease. Conclusion: History of hypertension is significantly associated with large infarcts in patients presenting with acute MI.

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