Brahim Harbaoui1, David Nanchen2, Pierre Lantelme3, Baris Gencer4, Dick Heg5, Roland Klingenberg6, Lorenz Räber7, David Carballo4, Christian M Matter6, Stephan Windecker7, François Mach4, Nicolas Rodondi8, Eric Eeckhout1, Pierre Monney1, Panagiotis Antiochos1, Juerg Schwitter1, Patrizio Pascale1, Stephane Fournier1, Pierre-Yves Courand3, Thomas F Lüscher6, Olivier Muller9. 1. Service of Cardiology, Lausanne University Hospital, Lausanne, Switzerland. 2. Department of Ambulatory Care and Community Medicine, University of Lausanne, Lausanne, Switzerland. 3. University Hospital la Croix-Rousse, Hospices Civils de Lyon, Lyon, France. 4. Division of Cardiology, Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland. 5. Institute of Social and Preventive Medicine, and Clinical Trials Unit, Department of Clinical Research, University of Bern, Bern, Switzerland. 6. Department of Cardiology, University Heart Center, University Hospital of Zurich, Zurich, Switzerland. 7. Department of Cardiology, University Hospital of Bern, Bern, Switzerland. 8. Department of General Internal Medicine, University Hospital of Bern, Bern, Switzerland. 9. Service of Cardiology, Lausanne University Hospital, Lausanne, Switzerland. Electronic address: Olivier.Muller@chuv.ch.
Abstract
BACKGROUND AND AIMS: 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). METHODS: 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. RESULTS: 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]. CONCLUSIONS: 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.
BACKGROUND AND AIMS: 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). METHODS: 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. RESULTS: 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]. CONCLUSIONS: 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.
Authors: Rosa M Valls; Anna Pedret; Lorena Calderón-Pérez; Elisabet Llauradó; Laura Pla-Pagà; Judit Companys; Ana Moragas; Francisco Martín-Luján; Yolanda Ortega; Montse Giralt; Marta Romeu; Laura Rubió; Jordi Mayneris-Perxachs; Núria Canela; Francesc Puiggrós; Antoni Caimari; Josep M Del Bas; Lluís Arola; Rosa Solà Journal: Eur J Nutr Date: 2020-07-13 Impact factor: 5.614
Authors: Jonathan Rilinger; Antonia M Riefler; Xavier Bemtgen; Markus Jäckel; Viviane Zotzmann; Paul M Biever; Daniel Duerschmied; Christoph Benk; Georg Trummer; Klaus Kaier; Christoph Bode; Dawid L Staudacher; Tobias Wengenmayer Journal: Clin Res Cardiol Date: 2021-03-29 Impact factor: 5.460
Authors: Judit Companys; Lorena Calderón-Pérez; Laura Pla-Pagà; Elisabet Llauradó; Berner Andrée Sandoval-Ramirez; Maria José Gosalbes; Ainara Arregui; Maddi Barandiaran; Antoni Caimari; Josep Maria Del Bas; Lluís Arola; Rosa M Valls; Rosa Solà; Anna Pedret Journal: Eur J Nutr Date: 2022-05-28 Impact factor: 4.865