Abstract
In patients with atherosclerotic disease, a high pulse pressure is an important predictor of cardiovascular events. However, in patients with chronic heart failure (CHF) a low pulse pressure is related to worse outcome, although no distinction was made between ischaemic and non ischaemic heart failure. We therefore aimed to compare the prognostic value of pulse pressure (PP) between those with ischaemic and non ischaemic advanced heart failure. Pulse pressure was analysed for its effect on mortality, adjusting for other modifiers of risk, using Cox proportional hazards regression analysis of data collected from 1901 patients with NYHA class III or IV heart failure (mean age 65 years, mean ejection fraction 26%). In ischaemic heart failure (n=1118), low mean arterial pressure (MAP) was an independent predictor of overall mortality (Hazard Ratio (HR) 0.88 per 10 mm Hg; p=0.04), while pulse pressure was not. In contrast, in non ischaemic heart failure (n=783), a low pulse pressure was an independent predictor of overall mortality (HR 0.84 per 10 mm Hg; p=0.036), while mean arterial pressure was not. In addition, higher NYHA class and lower pulse pressure (HR 0.87 per 10 mm Hg; p=0.002) were the only independent predictors for firs...Continue Reading
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