Heart failure & cardiomyopathies
Relationship Between Remote, Ambulatory Pulmonary Artery Pressures, and All-Cause Mortality in Patients With Chronic Heart Failure
Main finding · All-cause mortality by baseline PA diastolic, independent of other covariatesResult — go to the resultHazard ratio 1.04 95% CI 1.03–1.05Authors' conclusion
Baseline PAP (systolic, diastolic, and mean) and change in PAP (systolic, diastolic, and mean) from baseline to 6 months were independent predictors of 2-year mortality in patients with chronic HF in both preserved and reduced EF.
Study context
- Population
- Patients with chronic heart failure (HF) with a remote, ambulatory pulmonary artery (PA) pressure monitor, with reduced ejection fraction (EF) (<50%) and preserved EF (≥50%)Total N, all enrolled patients regardless of treatment assignments · CHAMPION 550 · GUIDE-HF 2,358 · US PAS 1,200 · MEMS-HF 234 · HF with reduced EF (<50%) 2,562 · HF with preserved EF (≥50%) 1,454
- Participants
- 4,342 patients
- Exposure
- Baseline pressure and change in pressure (increase/decrease/no change) from baseline to 6 months related to all-cause mortality over a 2-year follow-up period
- HF with reduced EFn = 2,562
- HF with preserved EFn = 1,454
- Outcome
- All-cause mortality by baseline PA diastolic, independent of other covariates
- Follow-up
- 2-year follow-up
Methodological detailsincluding all enrolled patients regardless of treatment assignments, landmark analysis
- Including all enrolled patients regardless of treatment assignments
- Landmark analysis
Main finding
As reported in the abstract
Hazard ratio
1.04
95% CI 1.03–1.05
P < 0.0001
Observational data: associations, not effects.
Further findings
Mortality after 6 months by change in PA diastolic from baseline to 6 months (continuous variable)
| Hazard ratio (95% CI) | P value | ||
|---|---|---|---|
| Change in PA diastolicLandmark analysis | 1.03 (1.01–1.05) | P = 0.0042 | |
| 0.512Hazard ratio (log scale) |
Mortality by change in PA diastolic from baseline to 6 months (categorical variable)
- Decrease of >2 mm Hg compared with no change: decrease in mortality
- 14.7%
- Increase of >2 mm Hg compared with no change: increase in mortality
- 26.7%
- P =0.0237
All-cause mortality by PA systolic and PA mean pressures, baseline and change from baseline to 6 months, in HF with reduced EF and HF with preserved EF
- Also predictive of all-cause mortality
Original publication
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