Association Between Pulse Pressure With All-Cause and Cardiac Mortality in Acute Coronary Syndrome: An Observational Cohort Study
BackgroundPulse pressure (PP) is a surrogate of aortic stiffness, and reflects cardiac performance and stroke volume. Previous studies have indicated that PP was a robust predictor of cardiovascular outcomes and mortality. However, results have been mixed, and very few studies have focused on the as...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-07-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2022.930755/full |
| _version_ | 1811225829942755328 |
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| author | Man Wang Wen Su Chun-Yan Jiang Wei-Ping Li Hui Chen Hong-Wei Li Hong-Wei Li |
| author_facet | Man Wang Wen Su Chun-Yan Jiang Wei-Ping Li Hui Chen Hong-Wei Li Hong-Wei Li |
| author_sort | Man Wang |
| collection | DOAJ |
| description | BackgroundPulse pressure (PP) is a surrogate of aortic stiffness, and reflects cardiac performance and stroke volume. Previous studies have indicated that PP was a robust predictor of cardiovascular outcomes and mortality. However, results have been mixed, and very few studies have focused on the association of PP with mortality in acute coronary syndrome (ACS). Thus, we aimed to investigate the relationship between admission PP and the prognosis of patients with ACS.MethodsThis cohort study included 10,824 patients diagnosed with ACS from the Cardiovascular Center Beijing Friendship Hospital Database Bank (CBDBANK) from January 2013 to October 2018. Patients with cardiogenic shock, malignancy, severe trauma and, no PP at admission were excluded. Restricted cubic spline and Cox proportional hazards regression were used to evaluate the association between PP and 1-year all-cause and cardiac mortality.ResultsIn the whole cohort, a total of 237 (2.19%) all-cause deaths were reported at 1-year follow-up. Restricted cubic spline analysis suggested a J-shaped relationship between PP and mortality. Among patients with ACS, both lower and higher PP levels were related to an increased risk of mortality (Pnon–linear < 0.001); with a PP level of 30 or 80 mmHg, as compared with 50 mmHg, the adjusted hazard ratios for 1-year all-cause mortality were 2.02 (95% CI, 1.27–3.22) and 1.62 (95% CI, 1.13–2.33), respectively, after adjustments for potential confounders. Similar results were observed for cardiac deaths. The J-shaped relationship between PP and mortality remained in a series of subgroup analyses.ConclusionOur results suggested that both low and high PP were associated with an increased risk of mortality in patients with ACS. |
| first_indexed | 2024-04-12T09:13:47Z |
| format | Article |
| id | doaj.art-718233f799814f7c9889d32e5d5da768 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-04-12T09:13:47Z |
| publishDate | 2022-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-718233f799814f7c9889d32e5d5da7682022-12-22T03:38:53ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2022-07-01910.3389/fcvm.2022.930755930755Association Between Pulse Pressure With All-Cause and Cardiac Mortality in Acute Coronary Syndrome: An Observational Cohort StudyMan Wang0Wen Su1Chun-Yan Jiang2Wei-Ping Li3Hui Chen4Hong-Wei Li5Hong-Wei Li6Department of Cardiology, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, Beijing, ChinaDepartment of Cardiology, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, Beijing, ChinaDepartment of Internal Medicine and Geriatrics, Beijing Friendship Hospital, Capital Medical University, Beijing, ChinaDepartment of Cardiology, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, Beijing, ChinaDepartment of Cardiology, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, Beijing, ChinaDepartment of Cardiology, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, Beijing, ChinaBeijing Key Laboratory of Metabolic Disorder Related Cardiovascular Disease, Beijing, ChinaBackgroundPulse pressure (PP) is a surrogate of aortic stiffness, and reflects cardiac performance and stroke volume. Previous studies have indicated that PP was a robust predictor of cardiovascular outcomes and mortality. However, results have been mixed, and very few studies have focused on the association of PP with mortality in acute coronary syndrome (ACS). Thus, we aimed to investigate the relationship between admission PP and the prognosis of patients with ACS.MethodsThis cohort study included 10,824 patients diagnosed with ACS from the Cardiovascular Center Beijing Friendship Hospital Database Bank (CBDBANK) from January 2013 to October 2018. Patients with cardiogenic shock, malignancy, severe trauma and, no PP at admission were excluded. Restricted cubic spline and Cox proportional hazards regression were used to evaluate the association between PP and 1-year all-cause and cardiac mortality.ResultsIn the whole cohort, a total of 237 (2.19%) all-cause deaths were reported at 1-year follow-up. Restricted cubic spline analysis suggested a J-shaped relationship between PP and mortality. Among patients with ACS, both lower and higher PP levels were related to an increased risk of mortality (Pnon–linear < 0.001); with a PP level of 30 or 80 mmHg, as compared with 50 mmHg, the adjusted hazard ratios for 1-year all-cause mortality were 2.02 (95% CI, 1.27–3.22) and 1.62 (95% CI, 1.13–2.33), respectively, after adjustments for potential confounders. Similar results were observed for cardiac deaths. The J-shaped relationship between PP and mortality remained in a series of subgroup analyses.ConclusionOur results suggested that both low and high PP were associated with an increased risk of mortality in patients with ACS.https://www.frontiersin.org/articles/10.3389/fcvm.2022.930755/fullpulse pressureacute coronary syndromeall-cause mortalitycardiac mortalitycohort study |
| spellingShingle | Man Wang Wen Su Chun-Yan Jiang Wei-Ping Li Hui Chen Hong-Wei Li Hong-Wei Li Association Between Pulse Pressure With All-Cause and Cardiac Mortality in Acute Coronary Syndrome: An Observational Cohort Study Frontiers in Cardiovascular Medicine pulse pressure acute coronary syndrome all-cause mortality cardiac mortality cohort study |
| title | Association Between Pulse Pressure With All-Cause and Cardiac Mortality in Acute Coronary Syndrome: An Observational Cohort Study |
| title_full | Association Between Pulse Pressure With All-Cause and Cardiac Mortality in Acute Coronary Syndrome: An Observational Cohort Study |
| title_fullStr | Association Between Pulse Pressure With All-Cause and Cardiac Mortality in Acute Coronary Syndrome: An Observational Cohort Study |
| title_full_unstemmed | Association Between Pulse Pressure With All-Cause and Cardiac Mortality in Acute Coronary Syndrome: An Observational Cohort Study |
| title_short | Association Between Pulse Pressure With All-Cause and Cardiac Mortality in Acute Coronary Syndrome: An Observational Cohort Study |
| title_sort | association between pulse pressure with all cause and cardiac mortality in acute coronary syndrome an observational cohort study |
| topic | pulse pressure acute coronary syndrome all-cause mortality cardiac mortality cohort study |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2022.930755/full |
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