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

Aims 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...

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Autores: Jackson, CE, Castagno, D, Maggioni, AP, Kober, L, Squire, IB, Swedberg, K, Andersson, B, Richards, AM, Bayes-Genis, A, Tribouilloy, C, Dobson, J, Ariti, CA, Poppe, KK, Earle, N, Whalley, G, Pocock, SJ, Doughty, RN, McMurray, JJV, Ordõez-Llanos J., Meta-Anal Global Grp Chronic He
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2015
País:España
Institución:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
Repositorio:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
OAI Identifier:oai:iibsantpau.fundanetsuite.com:p8679
Acceso en línea:https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=8679
Access Level:acceso abierto
Palabra clave:Pulse pressure
Heart failure
Reduced ejection fraction
Preserved ejection fraction
Mortality
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spelling Differing prognostic value of pulse pressure in patients with heart failure with reduced or preserved ejection fraction: results from the MAGGIC individual patient meta-analysisJackson, CECastagno, DMaggioni, APKober, LSquire, IBSwedberg, KAndersson, BRichards, AMBayes-Genis, ATribouilloy, CDobson, JAriti, CAPoppe, KKEarle, NWhalley, GPocock, SJDoughty, RNMcMurray, JJVOrdõez-Llanos J.Meta-Anal Global Grp Chronic HePulse pressureHeart failureReduced ejection fractionPreserved ejection fractionMortalityAims 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. Methods and results 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. Conclusion 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.OXFORD UNIV PRESS2015info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=8679EUROPEAN HEART JOURNALISSN: 0195668XISSNe: 15229645reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pauinstname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)Inglésinfo:eu-repo/semantics/openAccessoai:iibsantpau.fundanetsuite.com:p86792026-06-14T12:41:47Z
dc.title.none.fl_str_mv 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
title 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
spellingShingle 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
Jackson, CE
Pulse pressure
Heart failure
Reduced ejection fraction
Preserved ejection fraction
Mortality
title_short 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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_sort 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
dc.creator.none.fl_str_mv Jackson, CE
Castagno, D
Maggioni, AP
Kober, L
Squire, IB
Swedberg, K
Andersson, B
Richards, AM
Bayes-Genis, A
Tribouilloy, C
Dobson, J
Ariti, CA
Poppe, KK
Earle, N
Whalley, G
Pocock, SJ
Doughty, RN
McMurray, JJV
Ordõez-Llanos J.
Meta-Anal Global Grp Chronic He
author Jackson, CE
author_facet Jackson, CE
Castagno, D
Maggioni, AP
Kober, L
Squire, IB
Swedberg, K
Andersson, B
Richards, AM
Bayes-Genis, A
Tribouilloy, C
Dobson, J
Ariti, CA
Poppe, KK
Earle, N
Whalley, G
Pocock, SJ
Doughty, RN
McMurray, JJV
Ordõez-Llanos J.
Meta-Anal Global Grp Chronic He
author_role author
author2 Castagno, D
Maggioni, AP
Kober, L
Squire, IB
Swedberg, K
Andersson, B
Richards, AM
Bayes-Genis, A
Tribouilloy, C
Dobson, J
Ariti, CA
Poppe, KK
Earle, N
Whalley, G
Pocock, SJ
Doughty, RN
McMurray, JJV
Ordõez-Llanos J.
Meta-Anal Global Grp Chronic He
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Pulse pressure
Heart failure
Reduced ejection fraction
Preserved ejection fraction
Mortality
topic Pulse pressure
Heart failure
Reduced ejection fraction
Preserved ejection fraction
Mortality
description Aims 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. Methods and results 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. Conclusion 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.
publishDate 2015
dc.date.none.fl_str_mv 2015
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=8679
url https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=8679
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv OXFORD UNIV PRESS
publisher.none.fl_str_mv OXFORD UNIV PRESS
dc.source.none.fl_str_mv EUROPEAN HEART JOURNAL
ISSN: 0195668X
ISSNe: 15229645
reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
instname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
instname_str Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
reponame_str r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
collection r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
repository.name.fl_str_mv
repository.mail.fl_str_mv
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