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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

  • Datos identificativos

    Identificador: imarina:5131023
    Autores:
    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
    Resumen:
    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.
  • Otros:

    Autor según el artículo: 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
    Departamento: Medicina i Cirurgia
    Autor/es de la URV: Bardají Ruiz, Alfredo
    Palabras clave: 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
    Resumen: 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.
    Áreas temáticas: 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
    Acceso a la licencia de uso: https://creativecommons.org/licenses/by/3.0/es/
    Direcció de correo del autor: alfredo.bardaji@urv.cat
    Identificador del autor: 0000-0003-1900-6974
    Fecha de alta del registro: 2024-09-07
    Versión del articulo depositado: info:eu-repo/semantics/acceptedVersion
    Enlace a la fuente original: https://academic.oup.com/eurheartj/article/36/18/1106/2293212
    URL Documento de licencia: https://repositori.urv.cat/ca/proteccio-de-dades/
    Referencia al articulo segun fuente origial: European Heart Journal. 36 (18): 1106-1114
    Referencia de l'ítem segons les normes 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
    DOI del artículo: 10.1093/eurheartj/ehu490
    Entidad: Universitat Rovira i Virgili
    Año de publicación de la revista: 2015
    Tipo de publicación: Journal Publications
  • Palabras clave:

    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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