Abstract 15113: Diastolic Blood Pressure Predicts Mortality Risk in Patients With Cardiogenic Shock

Abstract

Background: Cardiogenic shock is a heterogeneous group with poorly defined hemodynamic goals and predictors of mortality. A common target for management has been empirically set at systolic blood pressure of 90 mm Hg or above and a mean arterial pressure value of over 60 mmHg. In this study, we have compared systolic and diastolic blood pressure in survivors and non-survivors with cardiogenic shock, and then in the subsets in heart failure-induced (HF-CS) versus acute myocardial infarction-induced cardiogenic shock (AMI-CS). Methods: A cohort of consecutive patients with cardiogenic shock admitted to our institution from 10/30/2019 to 11/11/2022 was analyzed retrospectively. Blood pressure was recorded on admission and then at 24-, 48-, and 72 hours post-admission. Independent t-testing was performed to evaluate the significance. Results: A total cohort consisted of 226 patients with cardiogenic shock (mean age 60.2+-14.5 years, 66% male), including 120 (53.1%) HF-CS and 78 (34.51%) AMI-CS. Diastolic blood pressure was higher in survivors than in non-survivors. Among patients with CS who survived, the diastolic BP was statistically higher than the patients who died at 24 and 48 hours from admission (p= 0.007 and 0.01. respectively). In patients with HF-CS, diastolic blood pressure was also higher at the same time points (p= 0.033 and 0.035, respectively). Neither systolic nor diastolic blood pressure differed between survivors and non-survivors in AMI-CS. Systolic blood pressure was similar in survivors and non-survivors in the whole cohort and in both subsets. Conclusions: Our data suggest that diastolic BP could be an early, consistent, and more reliable predictor of mortality than Systolic BP for CS patients, especially in the subset of HF-CS.