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Association of Arterial Pulse Pressure With Long-Term Clinical Outcomes in Patients With Heart Failure.

Publication ,  Journal Article
Laskey, WK; Wu, J; Schulte, PJ; Hernandez, AF; Yancy, CW; Heidenreich, PA; Bhatt, DL; Fonarow, GC
Published in: JACC Heart Fail
January 2016

OBJECTIVES: This study assessed the association between pulse pressure (PP) and adverse outcomes at 1 year in patients hospitalized for heart failure (HF). BACKGROUND: PP has been shown to be predictive of the development of HF. The value and utility of PP assessment in patients with prevalent HF is less clear. METHODS: We conducted a retrospective cohort study from clinical registry data linked to Medicare claims for 40,421 HF patients entered in the Get With the Guidelines-HF program. Cox proportional hazards models were used to estimate the association between discharge PP and all-cause mortality and the composite outcome of all-cause mortality/readmission by 1 year. RESULTS: A nonlinear association between PP and mortality (expressed as hazard ratio [HR] per 10-mm Hg increase in PP) was observed in patients with HF and reduced (<0.40) ejection fraction (EF). Risk decreased as PP increased up to 50 mm Hg (adjusted HR: 0.946; 95% confidence interval [CI]: 0.900 to 0.995; p = 0.03). When PP was ≥50 mm Hg, risk increased as PP increased (adjusted HR: 1.091; 95% CI: 1.050 to 1.135; p < 0.001). In patients with HF and preserved EF (≥0.40), there was a significant association between PP and mortality with risk increasing as PP increased, although the magnitude of the risk was significantly impacted by systolic blood pressure (SBP). Qualitatively similar observations were obtained for the composite outcome and use of EF ≥0.50 to define HF with preserved EF. CONCLUSIONS: The association between PP at hospital discharge and 1-year outcomes is a function of HF phenotype, SBP, and absolute PP.

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Published In

JACC Heart Fail

DOI

EISSN

2213-1787

Publication Date

January 2016

Volume

4

Issue

1

Start / End Page

42 / 49

Location

United States

Related Subject Headings

  • United States
  • Retrospective Studies
  • Registries
  • Prognosis
  • Practice Guidelines as Topic
  • Patient Discharge
  • Male
  • Humans
  • Heart Failure
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
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Laskey, W. K., Wu, J., Schulte, P. J., Hernandez, A. F., Yancy, C. W., Heidenreich, P. A., … Fonarow, G. C. (2016). Association of Arterial Pulse Pressure With Long-Term Clinical Outcomes in Patients With Heart Failure. JACC Heart Fail, 4(1), 42–49. https://doi.org/10.1016/j.jchf.2015.09.012
Laskey, Warren K., Jingjing Wu, Phillip J. Schulte, Adrian F. Hernandez, Clyde W. Yancy, Paul A. Heidenreich, Deepak L. Bhatt, and Gregg C. Fonarow. “Association of Arterial Pulse Pressure With Long-Term Clinical Outcomes in Patients With Heart Failure.JACC Heart Fail 4, no. 1 (January 2016): 42–49. https://doi.org/10.1016/j.jchf.2015.09.012.
Laskey WK, Wu J, Schulte PJ, Hernandez AF, Yancy CW, Heidenreich PA, et al. Association of Arterial Pulse Pressure With Long-Term Clinical Outcomes in Patients With Heart Failure. JACC Heart Fail. 2016 Jan;4(1):42–9.
Laskey, Warren K., et al. “Association of Arterial Pulse Pressure With Long-Term Clinical Outcomes in Patients With Heart Failure.JACC Heart Fail, vol. 4, no. 1, Jan. 2016, pp. 42–49. Pubmed, doi:10.1016/j.jchf.2015.09.012.
Laskey WK, Wu J, Schulte PJ, Hernandez AF, Yancy CW, Heidenreich PA, Bhatt DL, Fonarow GC. Association of Arterial Pulse Pressure With Long-Term Clinical Outcomes in Patients With Heart Failure. JACC Heart Fail. 2016 Jan;4(1):42–49.
Journal cover image

Published In

JACC Heart Fail

DOI

EISSN

2213-1787

Publication Date

January 2016

Volume

4

Issue

1

Start / End Page

42 / 49

Location

United States

Related Subject Headings

  • United States
  • Retrospective Studies
  • Registries
  • Prognosis
  • Practice Guidelines as Topic
  • Patient Discharge
  • Male
  • Humans
  • Heart Failure
  • Female