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Title: | Combining heart rate and systolic blood pressure to improve risk stratification in older patients with heart failure: Findings from the RICA Registry |
Author: | Sanchez Gil, Justo Manzano Espinosa, Luis Flather, M. Formiga Pérez, Francesc Conde Martel, Alicia Muela Molinero, Alberto Quiros Lopez, Raul Arias Jimenez, Jose Luis Iborra, Pau Llacer Pérez Calvo, Juan Ignacio Montero Pérez-Barquero, Manuel |
Keywords: | Infart de miocardi Mortalitat Pronòstic mèdic Myocardial infarction Mortality Prognosis |
Issue Date: | 1-Mar-2017 |
Publisher: | Elsevier B.V. |
Abstract: | Objectives: Heart rate (HR) and systolic blood pressure (SBP) are independent prognostic variables in patients with heart failure (HF). We evaluated if combining HR and SBP could improve prognostic assessment in older patients. Methods: Variables associated with all-cause mortality and readmission for HF during 9 months of follow-up were analyzed from the Spanish Heart Failure Registry (RICA). HR and SBP values were stratified in three combined groups. Results: We evaluated 1551 patients, 82 years and 56% women. Using HR strata of <70 and ≥70 bpm we found mortality rates of 9.8 and 13.6%, respectively (hazard ratio 1.0 and 1.35). For SBP ≥ 140, 120-140 and <120 mm Hg, mortality rates were 8.2, 10.4 and 20.3%. respectively (hazard ratio 1.0, 1.34 and 2.76). Using combined strata of HR < 70 bpm and SBP ≥ 140 mm Hg (n = 176; low-risk), HR < 70 and SBP < 140 + HR ≥ 70 and SBP < 120 (n = 1089; moderate-risk) and HR ≥ 70 and SBP < 120 (n = 286; high-risk) we found mortality rates of 4.5%, 11.0% and 24.0%, respectively. Multivariate Cox regression for all-cause mortality shows for low-, middle- and high-risk groups was 1 (reference), 1.93 (95% CI: 0.93-3.99, p = 0.077) and 4.32 (95% CI: 2.04-9.14, p < 0.001). BMI, NYHA, MDRD, hypertension and sodium were also independent prognostic factors. Conclusions: The combination provides better risk discrimination than use of HR and SBP alone and may provide a simple and reliable tool for risk assessment for older HF patients in clinical practice. |
Note: | Versió postprint del document publicat a: https://doi.org/10.1016/j.ijcard.2016.12.041 |
It is part of: | International Journal of Cardiology, 2017, vol. 230, p. 625-629 |
URI: | http://hdl.handle.net/2445/127925 |
Related resource: | https://doi.org/10.1016/j.ijcard.2016.12.041 |
ISSN: | 0167-5273 |
Appears in Collections: | Articles publicats en revistes (Ciències Clíniques) Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL)) |
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