Arterial excess-reservoir pressure integral as a predictor of cardiovascular complications in subjects with acute coronary syndrome.

Arterial excess-reservoir pressure integral as a predictor of cardiovascular complications in subjects with acute coronary syndrome.
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Schneider A, Krauze T, Mińczykowski A, Dziarmaga M, Piskorski J, Szczepanik A, Banaszak A, Guzik P, Wykrętowicz A,


Schneider A, Krauze T, Mińczykowski A, Dziarmaga M, Piskorski J, Szczepanik A, Banaszak A, Guzik P, Wykrętowicz A, (click to view)

Schneider A, Krauze T, Mińczykowski A, Dziarmaga M, Piskorski J, Szczepanik A, Banaszak A, Guzik P, Wykrętowicz A,

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Polish archives of internal medicine 2018 03 09() doi 10.20452/pamw.4222
Abstract

INTRODUCTION    The excess pressure-time integral (excessPTI) and the reservoir pressure-time integral (reservoirPTI) are new metrics derived from blood pressure (BP) waveform decomposition. These markers predict cardiovascular (CV) complications and are associated with target organ damage in treated hypertensive patients or subjects with chronic and acute heart failure. OBJECTIVES    Herein we investigated whether reservoirPTI or excessPTI predict future CV events (death, stroke, myocardial infarction) in subjects with acute coronary syndrome (ACS) and diminished ejection fraction (EF).  PATIENTS AND METHODS    BP waveforms were obtained by radial tonometry in 251 subjects with ACS (median age 64 years) and diminished EF (median 40%). Left ventricular EF was assessed by transthoracic echocardiography. ReservoirPTI and excessPTI were derived by decomposition of the BP waveform.  RESULTS    In all, 78 CV events (death, stroke, myocardial infarction) occurred during the follow-up period (median 1245 days). Kaplan-Meier analysis showed that the highest tertile of excessPTI was a significant predictor of adverse outcome. Multivariate Cox analysis demonstrated that excessPTI was a significant predictor of CV events after adjustment for EF, age, history of stroke, myocardial infarction and coronary artery bypass grafting [hazard ratio 1.9; 95% confidence interval 1.1-3.3; P = 0.02)].  CONCLUSIONS    In conclusion, excessPTI, a new metric derived from reservoir-pressure analysis, predicts outcome in survivors of ACS with diminished EF.

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