Rate-Pressure Product is a Novel Predictor for Short- and Long-Term Mortality in Patients with Acute Coronary Syndrome Undergoing Primary PCI/Immediate Invasive Strategy

IF 3.6 3区医学

Clinical Interventions in Aging Pub Date : 2024-03-23 DOI:10.2147/cia.s449905

Jian Zhou, Ya-Jie Li, Xiao-Dong Zhou, Li-Juan Wang

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引用次数: 0

Abstract

Background: Rate-pressure product (RPP) calculated by multiplying heart rate by systolic blood pressure, is a convenient indicator closely associated with cardiac work or myocardial oxygen consumption. It has been reported to relate strongly to important indices of cardiovascular risk in patients with myocardial ischemia. However, its relationship with short- and long-term mortality in patients with acute coronary syndrome (ACS) undergoing primary PCI/immediate invasive strategy has not been defined.
Methods: This study analyzed 1301 consecutive ACS patients who had undergone primary PCI, between January 2018 and September 2021. Patients with systolic BP < 90 mmHg were excluded to avoid the confounding effect of cardiogenic shock. RPP values were collected on admission and were divided into four groups: RPP ≤ 7.4, 7.4 ≤ 8.8, 8.8 < 8.8 < RPP8, and RPP > 10.8. Clinical endpoints were in-hospital cardiac and long-term all-cause mortality. The predictive performance was assessed by C-statistic, multivariate analysis and survival analysis.
Results: Multivariate analysis showed that these in the highest vs lowest category of RPP (> 10.8 vs ≤ 7.4) had OR of 4.33 (95% CI=1.10 − 17.01; P = 0.036) in in-hospital cardiac mortality and 3.15 (95% CI=1.24 − 8.00; P = 0.016) in long-term all-cause mortality. In C-statistic analyses, RPP was a strong predictor in ACS, STEMI or UA/NSTEMI group for in-hospital cardiac mortality (AUC = 0.746, 95% CI = 0.722– 0.770, p < 0.001) and long-term all-cause mortality (AUC = 0.701, 95% CI = 0.675– 0.725, p < 0.001). The Kaplan–Meier event rate for long-term survival of RPP > 10.8 was significantly lower than that of RPP ≤ 10.8.
Conclusion: RPP showed a positive association with in-hospital cardiac or long-term all-cause mortality in ACS patients undergoing primary PCI/immediate invasive strategy, and RPP > 10.8 can be as an independent predictor.

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速率-压力乘积是急性冠状动脉综合征患者接受初级 PCI/即刻介入策略治疗后短期和长期死亡率的新预测指标

背景：心率乘以收缩压计算出的心率-压力乘积（RPP）是一项与心脏工作或心肌耗氧量密切相关的便捷指标。据报道，它与心肌缺血患者心血管风险的重要指标密切相关。然而，在接受初级 PCI/即刻有创治疗的急性冠状动脉综合征（ACS）患者中，其与短期和长期死亡率的关系尚未明确：本研究分析了 2018 年 1 月至 2021 年 9 月间连续接受初级 PCI 治疗的 1301 例 ACS 患者。为避免心源性休克的混杂效应，排除了收缩压为 90 mmHg 的患者。入院时收集 RPP 值，并将其分为四组：RPP ≤ 7.4、7.4 ≤ 8.8、8.8 < 8.8 < RPP8 和 RPP > 10.8。临床终点为院内心脏病死亡率和长期全因死亡率。预测效果通过C统计量、多变量分析和生存分析进行评估：多变量分析表明，RPP最高与最低类别（> 10.8 vs ≤ 7.4）的住院心脏病死亡率OR为4.33（95% CI=1.10 - 17.01；P = 0.036），长期全因死亡率OR为3.15（95% CI=1.24 - 8.00；P = 0.016）。在 C 统计分析中，RPP 是 ACS、STEMI 或 UA/NSTEMI 组患者院内心脏死亡率（AUC = 0.746，95% CI = 0.722- 0.770，P < 0.001）和长期全因死亡率（AUC = 0.701，95% CI = 0.675- 0.725，P < 0.001）的有力预测因子。RPP > 10.8的长期生存卡普兰-梅耶事件率明显低于RPP ≤ 10.8的长期生存卡普兰-梅耶事件率：RPP与接受初治PCI/即刻有创策略的ACS患者的院内心脏或长期全因死亡率呈正相关，RPP > 10.8可作为一个独立的预测指标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Interventions in Aging GERIATRICS & GERONTOLOGY-

CiteScore

6.20

自引率

2.80%

发文量

193

期刊介绍： Clinical Interventions in Aging, is an online, peer reviewed, open access journal focusing on concise rapid reporting of original research and reviews in aging. Special attention will be given to papers reporting on actual or potential clinical applications leading to improved prevention or treatment of disease or a greater understanding of pathological processes that result from maladaptive changes in the body associated with aging. This journal is directed at a wide array of scientists, engineers, pharmacists, pharmacologists and clinical specialists wishing to maintain an up to date knowledge of this exciting and emerging field.