Heart failure & cardiomyopathies
Pulse pressure and aortic valve peak velocity and incident heart failure after myocardial infarction: a cohort study
Authors' conclusion
Pulse pressure and aortic valve peak velocity are significant predictors of heart failure with preserved ejection fraction in patients with myocardial infarction, suggesting their potential value in early risk stratification. These findings support the use of these markers to guide timely interventions aimed at preventing the progression to heart failure with preserved ejection fraction.
Study context
- Population
- Participants in the Atherosclerosis Risk in Communities Study free from heart failure at baseline, including individuals with a history of myocardial infarctionparticipants free from heart failure at baseline, including 802 with a history of myocardial infarction · history of myocardial infarction 802
- Participants
- 5,188 participants
- Exposure
- Associations of baseline pulse pressure and aortic valve peak velocity with heart failure subtypes
- Outcome
- Incident heart failure by subtype
- Follow-up
- 6 years
Methodological detailsretrospectively analysed, competing risk regression models
- Retrospectively analysed
- Competing risk regression models
Main finding
As reported in the abstract
Heart failure with preserved ejection fraction cases
217
Heart failure with preserved ejection fraction cases in patients with myocardial infarction
50
Heart failure with mildly reduced or reduced ejection fraction cases
127
Heart failure with mildly reduced or reduced ejection fraction cases in patients with myocardial infarction
33
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| Heart failure with preserved ejection fraction, per 1-SD increase (patients with myocardial infarction)Aortic valve peak velocity · per 1-SD increase | 1.37 (1.19–1.58) | |
| 0.512Hazard ratio (log scale) |
| Outcome | Estimate | P value |
|---|---|---|
| Heart failure with preserved ejection fraction, per 1-SD increase (patients with myocardial infarction)1-SD increase in pulse pressure | fold higher risk 1.60 (95% CI 1.30–1.97) | |
| Heart failure with preserved ejection fraction, by thresholdsPulse pressure ≥68 mm Hg vs lower pulse pressure | fold higher risk 3.83 | |
| Heart failure with preserved ejection fraction, by thresholdsAortic valve peak velocity ≥1.4 m/s vs lower values | fold higher risk 2.10 | |
| Heart failure with preserved ejection fraction by number of risk factors (elevated pulse pressure, aortic valve peak velocity, diabetes, atrial fibrillation) in patients with myocardial infarctionTwo or more risk factors vs without these risk factors | times the risk over 16 | P < 0.001 |
Original publication
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