Low systolic blood pressure on admission predicts mortality in patients with acute decompensated heart failure due to moderate to severe aortic stenosis.

Abstract

We investigated the relationship between admission systolic blood pressure (SBP) and all-cause mortality in patients hospitalized for acute decompensated heart failure (ADHF) because of aortic stenosis (AS). We retrospectively reviewed the data for 71 consecutive patients (mean age 85±7 years) who had been hospitalized for ADHF because of AS between January 2006 and August 2012. The primary endpoint of the study was the 1-year all-cause mortality. Clinical outcomes of patients who survived and those who died during a 1-year period were compared. Low admission SBP was defined as <120 mmHg. During the 1-year period, 26 (37%) of the 71 patients died, including 16 (57%) of 28 patients with low SBP and 10 (23%) of 43 patients with normal or high SBP (log-rank P=0.0065). In both the patients who survived and those who died, there were significant differences in admission SBP (152±43 vs. 116±32 mmHg, P<0.001), estimated glomerular filtration rate on admission (43.2±20.3 vs. 28.2±22.2 ml·min(-1)·1.73 m(-2), P=0.005), and left ventricular ejection fraction <50% (33% [15/45] vs. 65% [17/26], P=0.013). Low admission SBP independently predicted 1-year all-cause mortality (adjusted hazard ratio: 2.41, 95% confidence interval: 1.04-5.57, P=0.033). Low admission SBP is associated with significantly higher 1-year all-cause mortality in patients hospitalized for ADHF because of AS.