Prognostic value of pulse pressure after an acute coronary syndrome.

Détails

ID Serval
serval:BIB_109D84F77363
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Prognostic value of pulse pressure after an acute coronary syndrome.
Périodique
Atherosclerosis
Auteur(s)
Harbaoui B., Nanchen D., Lantelme P., Gencer B., Heg D., Klingenberg R., Räber L., Carballo D., Matter C.M., Windecker S., Mach F., Rodondi N., Eeckhout E., Monney P., Antiochos P., Schwitter J., Pascale P., Fournier S., Courand P.Y., Lüscher T.F., Muller O.
ISSN
1879-1484 (Electronic)
ISSN-L
0021-9150
Statut éditorial
Publié
Date de publication
10/2018
Peer-reviewed
Oui
Volume
277
Pages
219-226
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
Pulse pressure (PP) is a surrogate of aortic stiffness (AS) easily obtainable. The link between AS and cardio-vascular disease is documented, however, data regarding acute coronary syndrome (ACS) patients are scarce and contradictory. We aimed to assess the prognostic value of PP measured at admission, with regard to major adverse outcomes (all-cause mortality, recurrence of MI, and stroke), during the first year following an acute coronary syndrome (ACS).
The SPUM-ACS project is a prospective cohort study of patients with ACS conducted in 4 Swiss University hospitals. Patients with no PP at admission or with severe clinical heart failure or cardiogenic shock were excluded. Cox regression analyses were performed to determine associations between PP and outcomes (all-cause mortality, recurrence of myocardial infarction (MI), and stroke). Three multivariate Cox regression models were adjusted for hemodynamic, cardiovascular, and non-cardiovascular confounders, added successively.
Of 5635 eligible patients, 5070 met the inclusion criteria. Mean patient age was 63 years (range: 54-72), 79.6% were male, and mean blood pressure and PP were 93.9 ± 15.6 and 54 ± 17 mmHg, respectively. Multivariate analyses confirmed the prognostic significance of PP for each 10-mmHg increase for the composite endpoint, hazard ratio (HR) 1.126 [1.051-1.206], p = 0.001; all-cause mortality, HR1.129 [1.013-1.260], p = 0.029; and recurrence of MI, HR1.206 [1.102-1.320], p < 0.001; but not for stroke, HR1.014[0.853-1.205].
PP measured at admission is a strong, independent prognostic marker predicting mortality and recurrence of MI after ACS. PP should be considered for the management of secondary prevention.
Mots-clé
Acute coronary syndrome, Aortic stiffness, Cardiovascular events, Prognosis, Pulse pressure
Pubmed
Web of science
Création de la notice
31/07/2018 11:18
Dernière modification de la notice
20/08/2019 13:37
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