Article Impact Level: HIGH Data Quality: STRONG Summary of Clinical Cardiology, 47(4), e24261. https://doi.org/10.1002/clc.24261 Ying Liu et al.
Points
- The study investigated the relationship between 24-hour blood pressure variability (BPV) and mortality in patients with acute myocardial infarction (AMI).
- Data from 1291 AMI patients were analyzed, and the average real variability (ARV) of the first 24-hour blood pressure measurement in the intensive care unit (ICU) was calculated.
- Patients were categorized into four groups based on diastolic blood pressure (DBP)-ARV quartiles, and significant differences in 30-day, 1-year, and 3-year mortalities were observed among these groups.
- The highest DBP-ARV was strongly associated with increased 30-day, 1-year, and 3-year mortalities, indicating its potential as a prognostic indicator for short- and long-term mortality in AMI patients.
- The study’s findings provide important implications for therapeutic strategies aimed at reducing the risk of death in individuals with acute myocardial infarction.
Summary
The research investigated the association between 24-hour blood pressure variability (BPV) and mortality in patients with acute myocardial infarction (AMI). The retrospective cohort study, comprising 1291 AMI patients, utilized data from the MIMIC-IV 2.0 database. The average real variability (ARV) of the first 24-hour blood pressure measurement in the intensive care unit (ICU) was calculated, and patients were categorized into four groups based on ARV quartiles. The study sought to determine the impact of BPV on 30-day, 1-year, and 3-year all-cause mortalities, employing Cox regression, Kaplan–Meier curves, and restricted cubic spline (RCS) curves for data analysis.
The findings revealed significant differences in 30-day, 1-year, and 3-year mortalities among the four groups categorized by diastolic blood pressure (DBP)-ARV. After adjusting for confounding factors, it was observed that the highest DBP-ARV was strongly associated with increased 30-day, 1-year, and 3-year mortalities. Additionally, Kaplan–Meier curves demonstrated lower long-term survival probabilities for patients in the highest ARV group, irrespective of systolic blood pressure (SBP) or DBP. The study also highlighted the relationship between DBP-ARV and mortality risk, indicating that patients with AMI may face an elevated risk of short- and long-term death if their DBP-ARV is either higher or lower during the first 24 hours in the ICU.
In conclusion, the research provided valuable insights into the impact of blood pressure variability on the mortality of AMI patients. The study’s findings underscore the potential significance of DBP-ARV as a prognostic indicator for short- and long-term mortality in this patient population, offering important implications for therapeutic strategies aimed at reducing the risk of death in individuals with AMI.
Link to the article: https://onlinelibrary.wiley.com/doi/10.1002/clc.24261
References Liu, Y., Li, W., An, S., Zhai, Z., Liu, X., Hei, M., & Chen, G. (2024). Relationship between 24 h blood pressure variability and mortality in acute myocardial infarction patients. Clinical Cardiology, 47(4), e24261. https://doi.org/10.1002/clc.24261
