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Systolic blood pressure at Emergency Department presentation and 1-year mortality in acute chest pain patients

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Systolic blood pressure at Emergency Department presentation and 1-year mortality in acute chest pain patients. / Irfan, Affan; Haaf, Philip; Meissner, Julia; Twerenbold, Raphael; Reiter, Miriam; Reichlin, Tobias; Schaub, Nora; Zbinden, Anina; Heinisch, Corinna; Drexler, Beatrice; Winkler, Katrin; Mueller, Christian.

In: European Journal of Internal Medicine, Vol. 22, No. 5, 10.2011, p. 495-500.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Irfan, A, Haaf, P, Meissner, J, Twerenbold, R, Reiter, M, Reichlin, T, Schaub, N, Zbinden, A, Heinisch, C, Drexler, B, Winkler, K & Mueller, C 2011, 'Systolic blood pressure at Emergency Department presentation and 1-year mortality in acute chest pain patients', European Journal of Internal Medicine, vol. 22, no. 5, pp. 495-500. https://doi.org/10.1016/j.ejim.2011.06.009

APA

Irfan, A., Haaf, P., Meissner, J., Twerenbold, R., Reiter, M., Reichlin, T., Schaub, N., Zbinden, A., Heinisch, C., Drexler, B., Winkler, K., & Mueller, C. (2011). Systolic blood pressure at Emergency Department presentation and 1-year mortality in acute chest pain patients. European Journal of Internal Medicine, 22(5), 495-500. https://doi.org/10.1016/j.ejim.2011.06.009

Vancouver

Irfan A, Haaf P, Meissner J, Twerenbold R, Reiter M, Reichlin T et al. Systolic blood pressure at Emergency Department presentation and 1-year mortality in acute chest pain patients. European Journal of Internal Medicine. 2011 Oct;22(5):495-500. https://doi.org/10.1016/j.ejim.2011.06.009

Bibtex

@article{a24ab537b8d84f84889360c2a51a1fef,
title = "Systolic blood pressure at Emergency Department presentation and 1-year mortality in acute chest pain patients",
abstract = "Background: High blood pressure at rest has been an established risk factor for cardiovascular disease. However the relationship between Systolic Blood Pressure (SBP) and 1-year-mortality among acute chest pain patients presenting to Emergency Department (ED); and effects of preexisting renal insufficiency, hemodynamic stress - as quantified by Brain Natriuretic Peptide (BNP) and chest pain duration, on this relationship is unknown. Methods: Data was used from APACE (Advantageous Predictors of Acute Coronary Syndrome Evaluation), a prospective observational multicenter study of 1240 ED chest pain patients. SBP at presentation was categorized into quartiles: Q1 ≤ 127 mm Hg; Q2 128-142 mm Hg; Q3 143-160 mm Hg; Q4 ≥ 161 mm Hg. Results: 60 deaths occurred during 1-year. One-year-mortality-rate showed lower Hazard Ratios for Q2, Q3 and Q4 vs Q1 (HR [95% CI]; 0.39 (0.19-0.78), 0.34 (0.17-0.70), 0.35 (0.17-0.72); p < 0.01 respectively). Cox model adjusted for various demographic and treatment variables showed that participants in Q3 and Q4 had better prognoses than Q1. Patients showed progressively better prognosis from Q2 through Q4 vs Q1 only in patients who presented to ED with for more than 12 h of chest pain duration. Patients with renal insufficiency had lower SBP at presentation than others (p = 0.001). There was no association between the outcome and interaction variable of SBP quartiles and BNP (p = 0.27). Conclusion: Acute chest pain patients presenting to ED exhibit an inverse association between SBP at presentation and 1-year-mortality; a relationship which appears stronger in those who present with chest pain of greater than 12 h duration.",
keywords = "1-year mortality, Chest pain, High blood pressure, Risk stratification",
author = "Affan Irfan and Philip Haaf and Julia Meissner and Raphael Twerenbold and Miriam Reiter and Tobias Reichlin and Nora Schaub and Anina Zbinden and Corinna Heinisch and Beatrice Drexler and Katrin Winkler and Christian Mueller",
year = "2011",
month = oct,
doi = "10.1016/j.ejim.2011.06.009",
language = "English",
volume = "22",
pages = "495--500",
journal = "EUR J INTERN MED",
issn = "0953-6205",
publisher = "ELSEVIER SCIENCE BV",
number = "5",

}

RIS

TY - JOUR

T1 - Systolic blood pressure at Emergency Department presentation and 1-year mortality in acute chest pain patients

AU - Irfan, Affan

AU - Haaf, Philip

AU - Meissner, Julia

AU - Twerenbold, Raphael

AU - Reiter, Miriam

AU - Reichlin, Tobias

AU - Schaub, Nora

AU - Zbinden, Anina

AU - Heinisch, Corinna

AU - Drexler, Beatrice

AU - Winkler, Katrin

AU - Mueller, Christian

PY - 2011/10

Y1 - 2011/10

N2 - Background: High blood pressure at rest has been an established risk factor for cardiovascular disease. However the relationship between Systolic Blood Pressure (SBP) and 1-year-mortality among acute chest pain patients presenting to Emergency Department (ED); and effects of preexisting renal insufficiency, hemodynamic stress - as quantified by Brain Natriuretic Peptide (BNP) and chest pain duration, on this relationship is unknown. Methods: Data was used from APACE (Advantageous Predictors of Acute Coronary Syndrome Evaluation), a prospective observational multicenter study of 1240 ED chest pain patients. SBP at presentation was categorized into quartiles: Q1 ≤ 127 mm Hg; Q2 128-142 mm Hg; Q3 143-160 mm Hg; Q4 ≥ 161 mm Hg. Results: 60 deaths occurred during 1-year. One-year-mortality-rate showed lower Hazard Ratios for Q2, Q3 and Q4 vs Q1 (HR [95% CI]; 0.39 (0.19-0.78), 0.34 (0.17-0.70), 0.35 (0.17-0.72); p < 0.01 respectively). Cox model adjusted for various demographic and treatment variables showed that participants in Q3 and Q4 had better prognoses than Q1. Patients showed progressively better prognosis from Q2 through Q4 vs Q1 only in patients who presented to ED with for more than 12 h of chest pain duration. Patients with renal insufficiency had lower SBP at presentation than others (p = 0.001). There was no association between the outcome and interaction variable of SBP quartiles and BNP (p = 0.27). Conclusion: Acute chest pain patients presenting to ED exhibit an inverse association between SBP at presentation and 1-year-mortality; a relationship which appears stronger in those who present with chest pain of greater than 12 h duration.

AB - Background: High blood pressure at rest has been an established risk factor for cardiovascular disease. However the relationship between Systolic Blood Pressure (SBP) and 1-year-mortality among acute chest pain patients presenting to Emergency Department (ED); and effects of preexisting renal insufficiency, hemodynamic stress - as quantified by Brain Natriuretic Peptide (BNP) and chest pain duration, on this relationship is unknown. Methods: Data was used from APACE (Advantageous Predictors of Acute Coronary Syndrome Evaluation), a prospective observational multicenter study of 1240 ED chest pain patients. SBP at presentation was categorized into quartiles: Q1 ≤ 127 mm Hg; Q2 128-142 mm Hg; Q3 143-160 mm Hg; Q4 ≥ 161 mm Hg. Results: 60 deaths occurred during 1-year. One-year-mortality-rate showed lower Hazard Ratios for Q2, Q3 and Q4 vs Q1 (HR [95% CI]; 0.39 (0.19-0.78), 0.34 (0.17-0.70), 0.35 (0.17-0.72); p < 0.01 respectively). Cox model adjusted for various demographic and treatment variables showed that participants in Q3 and Q4 had better prognoses than Q1. Patients showed progressively better prognosis from Q2 through Q4 vs Q1 only in patients who presented to ED with for more than 12 h of chest pain duration. Patients with renal insufficiency had lower SBP at presentation than others (p = 0.001). There was no association between the outcome and interaction variable of SBP quartiles and BNP (p = 0.27). Conclusion: Acute chest pain patients presenting to ED exhibit an inverse association between SBP at presentation and 1-year-mortality; a relationship which appears stronger in those who present with chest pain of greater than 12 h duration.

KW - 1-year mortality

KW - Chest pain

KW - High blood pressure

KW - Risk stratification

UR - http://www.scopus.com/inward/record.url?scp=80052963614&partnerID=8YFLogxK

U2 - 10.1016/j.ejim.2011.06.009

DO - 10.1016/j.ejim.2011.06.009

M3 - SCORING: Journal article

C2 - 21925059

AN - SCOPUS:80052963614

VL - 22

SP - 495

EP - 500

JO - EUR J INTERN MED

JF - EUR J INTERN MED

SN - 0953-6205

IS - 5

ER -