%0 Journal Article %T U-Shaped Association Between Blood Pressure and Mortality Risk in ICU Patients With Atrial Fibrillation: The MIMIC-III Database. %A Shao Y %A Hu J %J Front Cardiovasc Med %V 9 %N 0 %D 2022 %M 35795360 %F 5.846 %R 10.3389/fcvm.2022.866260 %X UNASSIGNED: Existing evidence on the association between blood pressure (BP) and mortality risk in intensive care unit (ICU) patients with atrial fibrillation (AF) is scarce.
UNASSIGNED: This study aimed to assess the associations between blood pressure (BP) and risks of in-hospital and all-cause mortality in ICU patients with AF.
UNASSIGNED: A total of 2,345 records of patients with AF whose BP was monitored after admission to the ICU were obtained from the MIMIC-III database. Incidences were calculated for endpoints (hospital mortality, 7-day mortality, 30-day mortality, and 1-year mortality). We performed smooth curve and logistic regression analyses to evaluate the association between BP and the risk of each endpoint.
UNASSIGNED: Smooth curve regression showed that systolic blood pressure (SBP), mean arterial pressure (MBP), and diastolic blood pressure (DBP) followed U-shaped curves with respect to endpoints (hospital mortality, 7-day mortality, 30-day mortality, and 1-year mortality). The incidence of these endpoints was lowest at 110/70/55 mm Hg. There was an increased risk of 1-year mortality observed with BP > 110/70/55 mm Hg (SBP, odds ratio [OR] = 1.008, 95% CI 1.001-1.015, p = 0.0022; MBP, OR = 1.010, 95% CI 1.005-1.016, p < 0.001) after adjusting for age, sex, and medical history. In contrast, an inverse association between BP and the risk of 1-year mortality was observed with BP ≤ 110/70/55 mm Hg (SBP, OR = 0.981, 95% CI 0.974-0.988, p < 0.001; MBP OR = 0.959, 95% CI 0.939-0.979, p < 0.001; and DBP, OR = 0.970, 95% CI 0.957-0.983, p < 0.001).
UNASSIGNED: We observed a U-shaped association between BP and in-hospital/all-cause mortality in ICU patients with AF. However, the underlying causes need to be investigated.