Key result
An immediate increase in systolic blood pressure after TAVI was associated with a higher 1-year risk of death, myocardial infarction, or stroke compared to no increase (HR 2.42; 95% CI 1.03-5.7).
Why the study?
Changes in systemic blood pressure after TAVI have been described, but their prognostic value is not established.
Does an immediate increase in systolic blood pressure after TAVI predict worse 1-year clinical outcomes in patients with severe aortic stenosis?
Cohort (n=455)
No
Does an immediate increase in systolic blood pressure after TAVI predict worse 1-year clinical outcomes in patients with severe aortic stenosis?
Hazard Ratio: 2.42 (95% CI 1.03–5.7)
Absolute Event Rate: 13% vs 5.4%
p-value: p=0.033
An immediate increase in systolic blood pressure following TAVI is an independent predictor of worse 1-year cardiovascular outcomes, including death, MI, and stroke.
Introduction: Transcatheter aortic valve implantation (TAVI) has emerged as a common and effective treatment for patients with severe aortic stenosis. Changes in systemic blood pressure after TAVI have been described, yet their prognostic value is not established. Thus, we aimed to examine the association of the periprocedural changes in systolic blood pressure (SBP) and in pulse pressure on clinical outcomes after the procedure. Methods: A retrospective study of consecutive patients who underwent TAVI procedure in our medical center. We assessed the effect of the periprocedural changes in blood pressure measurements on mortality, acute myocardial infarction, stroke and hospitalizations at 1 year and on the combined outcome of death, myocardial infarction, and stroke 1 year following the procedure. Results: Our cohort included 455 patients (44% males). Of them, 343 patients (75.4%) had raised SBP immediately after the procedure. Patients with raised SBP had a significantly higher rate of the 1-year composite outcome, compared to patients who did not have a raise in SBP following the procedure (43 [13%] vs. 6 [5.4%], respectively, p = 0.033). After adjustment for age and sex, the postprocedural increase in SBP was significantly associated with the composite outcome, with a hazard ratio of 2.42, 95% CI: 1.03–5.7. Conclusion: An immediate increase in SBP after TAVI is associated with worse 1-year clinical cardiovascular outcomes.
No takes yet. Share an insight, caveat, or question.
Goldberg et al. (2024) conducted a cohort in Severe aortic stenosis (n=455). Raised systolic blood pressure immediately after TAVI vs. No raise in systolic blood pressure was evaluated on Combined outcome of death, myocardial infarction, and stroke at 1 year (HR 2.42, 95% CI 1.03-5.7, p=0.033). An immediate increase in systolic blood pressure after TAVI was associated with a higher 1-year risk of death, myocardial infarction, or stroke compared to no increase (HR 2.42; 95% CI 1.03-5.7).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: