HYPERTENSION AND PRE-EXISTING COMORBIDITIES ASSOCIATES WITH MAJOR ADVERSE CARDIAC EVENTS IN CORONARY ARTERY DISEASE PATIENTS ADMITTED TO INTENSIVE CARDIOVASCULAR CARE UNIT IN SANGLAH HOSPITAL: THE MANY FACES OF A SILENT KILLER

ABSTRACT

Background: Coronary artery disease (CAD) patients with a history of hypertension and underlying comorbidities are at high risk of developing major adverse cardiac events (MACE) and increase the mortality of the patients. Objective: This study aims to determine the association of hypertension and MACE in CAD patients admitted to ICCU. Method: This research is an analytic study with a cross-sectional approach. The data used is secondary data from the records of patients who were admitted to ICCU at Sanglah Hospital on 1 January 2021- 31 December 2021 with total sampling technique. Result: There were 376 patients included in this study. The majority of patients were male (n=291,77.4%) with the median overall patient age of 58 years old. Most of MACE found in the patients were revascularization (n=113;30.1%). The prevalence of hypertension was 19.1%. There were significant differences in length of in hemoglobin (p=0.006), lymphocytes count (p=0.002), uric acid (p=0.032) and GFR (p=0.000) in the patients classified based on MACE. MACE was significantly associated with hypertension (PR=1.285;95%CI=1.102-1.498;p=0.006). Chisquare analysis showed that stroke (PR=2.386;95%CI=1.271-4.480;p=0.007), heart failure (PR=2.533;95%CI=1.574-4.078;p=0.000), and malignant arrhythmia (PR=1.820;95%CI=1.229-2.694;p=0.004) were significantly associated with hypertension. Association of hypertension and kidney disease were significantly associated with stroke (PR= 2.386;95%CI=1.271-4.480;p=0.007), malignant arrhythmia (PR=1.820;95%CI=1.229-2.694;p=0.004) and heart failure (PR=2.533;95%CI=1.574-4.078;p=0.000). Association of hypertension and COVID-19 were also significantly associated with malignant arrhythmia (PR= 2.253;95%CI=1.309-3.877;p=0.011). Conclusion: There were significant association between hypertension with MACE in the patients. Intervention on these factors can prevent further mortality.