Pulse Pressure Initial and Arterial Pressure Mean as A Prognostic Death Information in Acute Myocardial Infarction Patients
Abstract
Background: Arterial blood pressure is an easily get variable, including systolic blood pressure, diastolic blood pressure, mean arterial pressure (MAP) and pulse pressure (PP). Although the variable blood pressure has clinical importance in many cardiovascular diseases, the variable that has become the best predictor in clinical practice cannot be determined. The purpose of this study is to determine the prognostic value of PP and MAP at the start of hospitalization in patients with acute myocardial infarction (IMA).
Subjects and Method: This was a retrospective cohort study conducted at cardiovascular intensive care unit, Dr. Moewardi Hospital, Surakarta, Central Java. A sample of 150 IMA patients from July 2013 to December 2013 was selected for this study. Blood pressure was measured the first time the patient arrives at the emergency unit to determine the value of PP and MAP. Then the patient was observed by looking at mortality during hospitalization as a final result. Basic characteristics data were analyzed using logistic regression and displayed in quartile form. The Kaplan-Meier curve was used to see mortality in each quartile. Cox proportional regression analysis was used to see the magnitude of the risk of variable PP, MAP and other variables on mortality.
Results: The highest mortality was found in the first quartile group of PP (OR= 1.81; p<0.001) and MAP (OR= 1.69; p<0.001). The Kaplan-Meier curve showed the first quartile of the two groups had the lowest survival, while the third highest quartile (p <0.001). The results of the cox analysis showed a decrease in mortality risk of 0.49 per increase in PP by 10 mmHg (95% CI= 0.07 to 1.00; p= 0.044) and 0.31 each increase in MAP by 10 mmHg (95% CI= 0.09 to 0.53; p= 0.003).
Conclusions: Blood pressure measurement can produce two variables as predictors of mortality in IMA patients, namely PP and MAP. Low PP and MAP are associated with higher mortality during hospitalization in IMA patients.
Keywords: Pulse pressure, mean arterial pressure, acute myocardial infarction, mortality
Correspondence: Budi Patria Meilus. Department of Cardiovascular, Faculty of Medicine, Universitas Sebelas Maret, Universitas Sebelas Maret, Jl. Ir. Sutami 36A, Surakarta 57126, Central Java.Email: budipatriamp@gmail.com. Mobile : +6281228355615.
Indonesian Journal of Medicine (2019), 4(2): 88-95
https://doi.org/10.26911/theijmed.2019.04.02.02
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