Correlation of pre- and in-hospital systolic blood pressure in acute heart failure patients and the prognostic implications: Report from the tokyo cardiac care unit network emergency medical service database

Tokyo CCU Network Scientific Committee

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: Systolic blood pressure (SBP) is an important prognostic indicator for patients with acute heart failure (AHF). However, its changes and the effects in the different phases of the acute management process are not well known. Methods and Results: The Tokyo CCU Network prospectively collects on-site information about AHF from emergency medical services (EMS) and the emergency room (ER). The association between in-hospital death and SBP at 2 different time points (on-site SBP [measured by EMS] and in-hospital SBP [measured at the ER; ER-SBP]) was analyzed. From 2010 to 2012, a total of 5,669 patients were registered and stratified into groups according to both their on-site SBP and ER-SBP: >160 mmHg; 100–160 mmHg; and <100 mmHg. In-hospital mortality rates increased when both on-site SBP and ER-SBP were low. After multivariate adjustment, both SBPs were inversely associated with in-hospital death. Notably, the risk for patients with ER-SBP of 100–160 mmHg (intermediate risk) differed according to their on-site SBP; those with on-site SBP <100 or 100–160 mmHg were at higher risk (OR, 7.39; 95% CI, 4.00–13.6 and OR, 2.73; 95% CI, 1.83–4.08, respectively [P<0.001 for both]) than patients with on-site SBP >160 mmHg. Conclusions: Monitoring changes in SBP assisted risk stratification of AHF patients, particularly patients with intermediate ER-SBP measurements.

Original languageEnglish
Pages (from-to)2473-2481
Number of pages9
JournalCirculation Journal
Volume80
Issue number12
DOIs
Publication statusPublished - 2016

Fingerprint

Tokyo
Emergency Medical Services
Heart Failure
Databases
Blood Pressure
Hospital Emergency Service

Keywords

  • Acute heart failure
  • Blood pressure change
  • Emergency medical service
  • Risk stratification
  • Systolic blood pressure

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

@article{639dac9b37e54ee18c1624fb8b0f685c,
title = "Correlation of pre- and in-hospital systolic blood pressure in acute heart failure patients and the prognostic implications: Report from the tokyo cardiac care unit network emergency medical service database",
abstract = "Background: Systolic blood pressure (SBP) is an important prognostic indicator for patients with acute heart failure (AHF). However, its changes and the effects in the different phases of the acute management process are not well known. Methods and Results: The Tokyo CCU Network prospectively collects on-site information about AHF from emergency medical services (EMS) and the emergency room (ER). The association between in-hospital death and SBP at 2 different time points (on-site SBP [measured by EMS] and in-hospital SBP [measured at the ER; ER-SBP]) was analyzed. From 2010 to 2012, a total of 5,669 patients were registered and stratified into groups according to both their on-site SBP and ER-SBP: >160 mmHg; 100–160 mmHg; and <100 mmHg. In-hospital mortality rates increased when both on-site SBP and ER-SBP were low. After multivariate adjustment, both SBPs were inversely associated with in-hospital death. Notably, the risk for patients with ER-SBP of 100–160 mmHg (intermediate risk) differed according to their on-site SBP; those with on-site SBP <100 or 100–160 mmHg were at higher risk (OR, 7.39; 95{\%} CI, 4.00–13.6 and OR, 2.73; 95{\%} CI, 1.83–4.08, respectively [P<0.001 for both]) than patients with on-site SBP >160 mmHg. Conclusions: Monitoring changes in SBP assisted risk stratification of AHF patients, particularly patients with intermediate ER-SBP measurements.",
keywords = "Acute heart failure, Blood pressure change, Emergency medical service, Risk stratification, Systolic blood pressure",
author = "{Tokyo CCU Network Scientific Committee} and Yasuyuki Shiraishi and Shun Kohsaka and Kazumasa Harada and Takamichi Miyamoto and Shuzou Tanimoto and Kiyoshi Iida and Tetsuro Sakai and Tetsuro Miyazaki and Mayuko Yagawa and Kenichi Matsushita and Shuta Furihata and Naoki Sato and Keiichi Fukuda and Takeshi Yamamoto and Ken Nagao and Morimasa Takayama",
year = "2016",
doi = "10.1253/circj.CJ-16-0837",
language = "English",
volume = "80",
pages = "2473--2481",
journal = "Circulation Journal",
issn = "1346-9843",
publisher = "Japanese Circulation Society",
number = "12",

}

TY - JOUR

T1 - Correlation of pre- and in-hospital systolic blood pressure in acute heart failure patients and the prognostic implications

T2 - Report from the tokyo cardiac care unit network emergency medical service database

AU - Tokyo CCU Network Scientific Committee

AU - Shiraishi, Yasuyuki

AU - Kohsaka, Shun

AU - Harada, Kazumasa

AU - Miyamoto, Takamichi

AU - Tanimoto, Shuzou

AU - Iida, Kiyoshi

AU - Sakai, Tetsuro

AU - Miyazaki, Tetsuro

AU - Yagawa, Mayuko

AU - Matsushita, Kenichi

AU - Furihata, Shuta

AU - Sato, Naoki

AU - Fukuda, Keiichi

AU - Yamamoto, Takeshi

AU - Nagao, Ken

AU - Takayama, Morimasa

PY - 2016

Y1 - 2016

N2 - Background: Systolic blood pressure (SBP) is an important prognostic indicator for patients with acute heart failure (AHF). However, its changes and the effects in the different phases of the acute management process are not well known. Methods and Results: The Tokyo CCU Network prospectively collects on-site information about AHF from emergency medical services (EMS) and the emergency room (ER). The association between in-hospital death and SBP at 2 different time points (on-site SBP [measured by EMS] and in-hospital SBP [measured at the ER; ER-SBP]) was analyzed. From 2010 to 2012, a total of 5,669 patients were registered and stratified into groups according to both their on-site SBP and ER-SBP: >160 mmHg; 100–160 mmHg; and <100 mmHg. In-hospital mortality rates increased when both on-site SBP and ER-SBP were low. After multivariate adjustment, both SBPs were inversely associated with in-hospital death. Notably, the risk for patients with ER-SBP of 100–160 mmHg (intermediate risk) differed according to their on-site SBP; those with on-site SBP <100 or 100–160 mmHg were at higher risk (OR, 7.39; 95% CI, 4.00–13.6 and OR, 2.73; 95% CI, 1.83–4.08, respectively [P<0.001 for both]) than patients with on-site SBP >160 mmHg. Conclusions: Monitoring changes in SBP assisted risk stratification of AHF patients, particularly patients with intermediate ER-SBP measurements.

AB - Background: Systolic blood pressure (SBP) is an important prognostic indicator for patients with acute heart failure (AHF). However, its changes and the effects in the different phases of the acute management process are not well known. Methods and Results: The Tokyo CCU Network prospectively collects on-site information about AHF from emergency medical services (EMS) and the emergency room (ER). The association between in-hospital death and SBP at 2 different time points (on-site SBP [measured by EMS] and in-hospital SBP [measured at the ER; ER-SBP]) was analyzed. From 2010 to 2012, a total of 5,669 patients were registered and stratified into groups according to both their on-site SBP and ER-SBP: >160 mmHg; 100–160 mmHg; and <100 mmHg. In-hospital mortality rates increased when both on-site SBP and ER-SBP were low. After multivariate adjustment, both SBPs were inversely associated with in-hospital death. Notably, the risk for patients with ER-SBP of 100–160 mmHg (intermediate risk) differed according to their on-site SBP; those with on-site SBP <100 or 100–160 mmHg were at higher risk (OR, 7.39; 95% CI, 4.00–13.6 and OR, 2.73; 95% CI, 1.83–4.08, respectively [P<0.001 for both]) than patients with on-site SBP >160 mmHg. Conclusions: Monitoring changes in SBP assisted risk stratification of AHF patients, particularly patients with intermediate ER-SBP measurements.

KW - Acute heart failure

KW - Blood pressure change

KW - Emergency medical service

KW - Risk stratification

KW - Systolic blood pressure

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U2 - 10.1253/circj.CJ-16-0837

DO - 10.1253/circj.CJ-16-0837

M3 - Article

C2 - 27795486

AN - SCOPUS:84997216949

VL - 80

SP - 2473

EP - 2481

JO - Circulation Journal

JF - Circulation Journal

SN - 1346-9843

IS - 12

ER -