Acute cardiac care & resuscitation
Impact of Blood Pressure Targets in Patients With Heart Failure Undergoing Postresuscitation Care: A Subgroup Analysis From a Randomized Controlled Trial
Authors' conclusion
In resuscitated patients with out-of-hospital cardiac arrest with a history of heart failure, allocation to a higher blood pressure target resulted in significantly increased heart rate in the higher blood pressure-target group. However, no certain differences was found for cardiac index, left ventricular ejection fraction or stroke volume.
Study context
- Population
- Comatose resuscitated OHCA patients with a history of HF, postresuscitation intensive care17% of BOX cohort
- Participants
- 134 participants
- Comparison
- Mean arterial pressure (MAP) target 77 mm Hg vs 63 mm Hg
- MAP77n = 71
- Primary endpoint
- Cardiac index
- Follow-up
- First 72 hours
Methodological detailssubgroup analysis, double-blinded, multicentre
- Subgroup analysis
- Double-blinded
- Multicentre
Primary result
As reported in the abstract
during 72 h
Mean difference in cardiac index between groups, L/min·m-2 (95% CI, −0.04 to 0.35); Pgroup=0.22
0.15
Secondary outcomes
Cardiac index at ICU arrival
| Outcome | Mean difference (beats/min) (CI) | P value | |
|---|---|---|---|
| Heart rateSignificantly elevated with MAP77 | 6 (1–12) | Pgroup=0.03 | |
| −5051015Difference, beats/min (linear scale) |
- Cardiac index at ICU arrival: P=0.92
LVEF and stroke volume
- Similar between the groups
Vasopressor usage
- Significantly increased
- P = 0.006
All-cause mortality · 365 days
- Died, overall
- 69 (51%)
- Adjusted HR for 365-day mortality (0.84-2.27), P=0.20
- 1.38
Renal replacement therapy
- Adjusted OR for RRT (0.84-8.89; P=0.09)
- 2.73
Original publication
Impact of Blood Pressure Targets in Patients With Heart Failure Undergoing Postresuscitation Care: A Subgroup Analysis From a Randomized Controlled Trial. Circ Heart Fail. Published 7 June 2024. doi:10.
Summarised from the published abstract; every number is checked against it