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Differing prognostic value of pulse pressure in patients with heart failure with reduced or preserved ejection fraction: results from the MAGGIC individual patient meta-analysis

  • Identification data

    Identifier: imarina:5131023
    Authors:
    Jackson, Colette E.Castagno, DavideMaggioni, Aldo P.Kober, LarsSquire, Iain B.Swedberg, KarlAndersson, BertRichards, A. MarkBayes-Genis, AntoniTribouilloy, ChristopheDobson, JoannaAriti, Cono A.Poppe, Katrina K.Earle, NikkiWhalley, GillianPocock, Stuart J.Doughty, Robert N.McMurray, John J. V.Meta-Anal Global Grp Chronic He
    Abstract:
    Low pulse pressure is a marker of adverse outcome in patients with heart failure (HF) and reduced ejection fraction (HF-REF) but the prognostic value of pulse pressure in patients with HF and preserved ejection fraction (HF-PEF) is unknown. We examined the prognostic value of pulse pressure in patients with HF-PEF [ejection fraction (EF) ? 50%] and HF-REF.Data from 22 HF studies were examined. Preserved left ventricular ejection fraction (LVEF) was defined as LVEF ? 50%. All-cause mortality at 3 years was evaluated in 27 046 patients: 22 038 with HF-REF (4980 deaths) and 5008 with HF-PEF (828 deaths). Pulse pressure was analysed in quintiles in a multivariable model adjusted for the previously reported Meta-Analysis Global Group in Chronic Heart Failure prognostic variables. Heart failure and reduced ejection fraction patients in the lowest pulse pressure quintile had the highest crude and adjusted mortality risk (adjusted hazard ratio 1.68, 95% confidence interval 1.53-1.84) compared with all other pulse pressure groups. For patients with HF-PEF, higher pulse pressure was associated with the highest crude mortality, a gradient that was eliminated after adjustment for other prognostic variables.Lower pulse pressure (especially <53 mmHg) was an independent predictor of mortality in patients with HF-REF, particularly in those with an LVEF < 30% and systolic blood pressure <140 mmHg. Overall, this relationship between pulse pressure and outcome was not consistently observed among patients with HF-PEF.Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.
  • Others:

    Author, as appears in the article.: Jackson, Colette E.; Castagno, Davide; Maggioni, Aldo P.; Kober, Lars; Squire, Iain B.; Swedberg, Karl; Andersson, Bert; Richards, A. Mark; Bayes-Genis, Antoni; Tribouilloy, Christophe; Dobson, Joanna; Ariti, Cono A.; Poppe, Katrina K.; Earle, Nikki; Whalley, Gillian; Pocock, Stuart J.; Doughty, Robert N.; McMurray, John J. V.;Meta-Anal Global Grp Chronic He
    Department: Medicina i Cirurgia
    URV's Author/s: Bardají Ruiz, Alfredo
    Keywords: Wave velocity Survival Risk Reduced ejection fraction Pulse pressure Preserved ejection fraction Onset atrial-fibrillation Mortality Independent predictor Heart failure Differential impact Blood-pressure Association Acute myocardial-infarction pulse pressure preserved ejection fraction mortality heart failure
    Abstract: Low pulse pressure is a marker of adverse outcome in patients with heart failure (HF) and reduced ejection fraction (HF-REF) but the prognostic value of pulse pressure in patients with HF and preserved ejection fraction (HF-PEF) is unknown. We examined the prognostic value of pulse pressure in patients with HF-PEF [ejection fraction (EF) ? 50%] and HF-REF.Data from 22 HF studies were examined. Preserved left ventricular ejection fraction (LVEF) was defined as LVEF ? 50%. All-cause mortality at 3 years was evaluated in 27 046 patients: 22 038 with HF-REF (4980 deaths) and 5008 with HF-PEF (828 deaths). Pulse pressure was analysed in quintiles in a multivariable model adjusted for the previously reported Meta-Analysis Global Group in Chronic Heart Failure prognostic variables. Heart failure and reduced ejection fraction patients in the lowest pulse pressure quintile had the highest crude and adjusted mortality risk (adjusted hazard ratio 1.68, 95% confidence interval 1.53-1.84) compared with all other pulse pressure groups. For patients with HF-PEF, higher pulse pressure was associated with the highest crude mortality, a gradient that was eliminated after adjustment for other prognostic variables.Lower pulse pressure (especially <53 mmHg) was an independent predictor of mortality in patients with HF-REF, particularly in those with an LVEF < 30% and systolic blood pressure <140 mmHg. Overall, this relationship between pulse pressure and outcome was not consistently observed among patients with HF-PEF.Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.
    Thematic Areas: Saúde coletiva Nutrição Medicina iii Medicina ii Medicina i Interdisciplinar General medicine Farmacia Educação física Direito Ciências biológicas ii Ciências biológicas i Cardiology and cardiovascular medicine Cardiac & cardiovascular systems
    licence for use: https://creativecommons.org/licenses/by/3.0/es/
    Author's mail: alfredo.bardaji@urv.cat
    Author identifier: 0000-0003-1900-6974
    Record's date: 2024-09-07
    Papper version: info:eu-repo/semantics/acceptedVersion
    Link to the original source: https://academic.oup.com/eurheartj/article/36/18/1106/2293212
    Licence document URL: https://repositori.urv.cat/ca/proteccio-de-dades/
    Papper original source: European Heart Journal. 36 (18): 1106-1114
    APA: Jackson, Colette E.; Castagno, Davide; Maggioni, Aldo P.; Kober, Lars; Squire, Iain B.; Swedberg, Karl; Andersson, Bert; Richards, A. Mark; Bayes-Geni (2015). Differing prognostic value of pulse pressure in patients with heart failure with reduced or preserved ejection fraction: results from the MAGGIC individual patient meta-analysis. European Heart Journal, 36(18), 1106-1114. DOI: 10.1093/eurheartj/ehu490
    Article's DOI: 10.1093/eurheartj/ehu490
    Entity: Universitat Rovira i Virgili
    Journal publication year: 2015
    Publication Type: Journal Publications
  • Keywords:

    Cardiac & Cardiovascular Systems,Cardiology and Cardiovascular Medicine
    Wave velocity
    Survival
    Risk
    Reduced ejection fraction
    Pulse pressure
    Preserved ejection fraction
    Onset atrial-fibrillation
    Mortality
    Independent predictor
    Heart failure
    Differential impact
    Blood-pressure
    Association
    Acute myocardial-infarction
    pulse pressure
    preserved ejection fraction
    mortality
    heart failure
    Saúde coletiva
    Nutrição
    Medicina iii
    Medicina ii
    Medicina i
    Interdisciplinar
    General medicine
    Farmacia
    Educação física
    Direito
    Ciências biológicas ii
    Ciências biológicas i
    Cardiology and cardiovascular medicine
    Cardiac & cardiovascular systems
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