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The Impact of Short-Term Blood Pressure Variability on All-Cause Mortality in Patients With Acute Myocardial
Ying Liu1,2, Sijia Jiang3, Wen Li1,2
1Department of Cardiology, China-Japan Friendship Hospital, Beijing, China, zryhyy.com.cn.
Background:
Blood pressure variability (BPV) is recognized as an independent risk factor for cardiovascular morbidity and mortality. However, findings regarding the association between the coefficient of variation (CV) of 24-h blood pressure and mortality in patients with acute myocardial infarction (AMI) remain inconsistent. The aim of this study was to examine the association between 24-h CV and the risk of in-hospital, 30-day, 1-year, and 3-year mortality in AMI patients.
Methods:
This retrospective cohort study included AMI patients who were admitted to the intensive care unit (ICU) from the MIMIC-IV 2.0 database. The CV was calculated from blood pressure measurements taken during the first 24 h. Patients were divided into three groups according to tertiles of 24-h blood pressure CV. The relationship between 24-h CV and the risk of all-cause mortality in AMI patients was analyzed using logistic regression, Cox proportional hazards regression, and Kaplan-Meier survival analyses.
Results:
A total of 1291 eligible AMI patients were included. Compared with Q1 (lowest CV), Q3 (highest 24-h systolic blood pressure [SBP]-CV) was significantly associated with an increased risk of in-hospital (odds ratio [OR]: 3.333, 95% confidence interval [CI]: 1.725-6.439), 30-day (hazard ratio [HR]: 1.868, 95% CI: 1.201-2.904), and 1-year (HR: 1.420, 95% CI: 1.058-1.907) mortality. Both Q2 and Q3 of 24-h diastolic blood pressure (DBP)-CV were significantly associated with an increased risk of in-hospital, 30-day, 1-year, and 3-year mortality. Kaplan-Meier survival curves demonstrated that patients in Q3 had significantly lower 30-day, 1-year, and 3-year survival probabilities than those in other tertiles for both SBP and DBP.
Conclusions:
Our findings suggest that 24-h SBP-CV and DBP-CV are significantly associated with both short- and long-term outcomes in AMI patients. BPV may serve as a prognostic marker for all-cause mortality in AMI patients.
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