Association between mean arterial pressure during the first 24 hours and hospital mortality in patients with cardiogenic shock

Abstract

Abstract Background The optimal MAP target for patients with cardiogenic shock (CS) remains unknown. We sought to determine the relationship between mean arterial pressure (MAP) and mortality in the cardiac intensive care unit (CICU) patients with CS. Methods Using a single-center database of CICU patients admitted between 2007 and 2015, we identified patients with an admission diagnosis of CS. MAP was measured every 15 min, and the mean of all MAP values during the first 24 h (mMAP24) was recorded. Multivariable logistic regression determined the relationship between mMAP24 and adjusted hospital mortality. Results We included 1002 patients with a mean age of 68 ± 13.7 years, including 36% females. Admission diagnoses included acute coronary syndrome in 60%, heart failure in 74%, and cardiac arrest in 38%. Vasoactive drugs were used in 72%. The mMAP24 was higher (75 vs. 71 mmHg, p 0.1). Conclusion In patients with CS, we observed an inverse relationship between mMAP24 and hospital mortality. The poor outcomes in patients with mMAP24 < 65 mmHg provide indirect evidence supporting a MAP goal of 65 mmHg for patients with CS.

Keywords

• Cardiogenic shock
• Shock
• Cardiac intensive care unit
• Critical care
• Mortality
• Hypotension