Acute cardiac care & resuscitationCohort study
Minimum Mean Arterial Pressure and Associated Mortality Outcomes in the Cardiac Intensive Care Unit
- retrospective, single-center study
Authors' conclusion
We observed a graded association between lower minMAP and increased mortality, re-emphasizing severe hypotension as a critical physiological marker of patient vulnerability.
Study context
- Population
- Adult cardiac intensive care unit (CICU) patients (2007–2018)
- Participants
- 11,930 patients
- Exposure
- Four minimum mean arterial pressure (minMAP) groups within the first 24 hours of CICU admission, categorized using a classification and regression tree model
- ≥57n = 5,053
- 48 to 57n = 3,635
- 37 to 48n = 2,392
- <37n = 850
- Outcome
- In-hospital mortality
Main finding
As reported in the abstract
Adjusted odds ratio (CI)P value
minMAP <48 mm Hghigher mortality with minMAP <48 mm Hg
1.60(1.36–1.88)
P < 0.001minMAP <37 mm Hghighest risk with minMAP <37 mm Hg
2.19(1.67–2.86)
P < 0.001- In-hospital mortality
- 9.1% (n = 1,080)
Observational data: associations, not effects.
Further findings
30-day mortality
| Comparison | adjusted HR (CI) | P value | |
|---|---|---|---|
| minMAP <48 mm Hg · higher mortality with minMAP <48 mm Hg | 1.47 (1.31–1.65) | P < 0.001 | |
| minMAP <37 mm Hg · highest risk with minMAP <37 mm Hg | 1.95 (1.61–2.36) | P < 0.001 | |
| 0.512Adjusted hazard ratio (log scale) |
- 30-day mortality — Died within 30-days of CICU admission
- 11.7% (n = 1,364)
- 30-day mortality — 30-day mortality by the Kaplan-Meier method
- 11.7% [11.1% to 12.3%]
Median minMAP · first 24 hours
- Median minMAP
- 54 (47, 62) mm Hg
Shape of association between minMAP and mortality
- Lower minMAP incrementally associated with higher mortality in a continuous, reverse J-shaped manner; lowest mortality at
- 71 to 75 mm Hg
- Lower minMAP associated with higher mortality across admission diagnoses and regardless of vasoactive drugs administration
Original publication
Minimum Mean Arterial Pressure and Associated Mortality Outcomes in the Cardiac Intensive Care Unit. JACC Adv. Published 21 January 2026. doi:10.1016/j.jacadv.2025.102543
Summarised from the published abstract; every number is checked against it