The Association Between Blood Pressure and Clinical Outcomes in Patients Undergoing Transcatheter Aortic Valve Implantation

Abstract

Introduction: Transcatheter Aortic Valve Implantation (TAVI) has emerged as a common and effective treatment for patients with severe aortic stenosis. Changes in systemic blood pressure after TAVI have been described, yet their prognostic value are not established. Thus, we aimed to examine the association of the peri-procedural changes in systolic blood pressure and in pulse pressure on clinical outcomes after the procedure. Methods: A retrospective study of consecutive patients who underwent TAVI procedure in our medical center. We assessed the effect of the periprocedural changes in blood pressure measurements on mortality, acute myocardial infarction, stroke and hospitalizations at 1-year and on the combined outcome of death, myocardial infarction and stroke at one year following the procedure. Results: Our cohort included 455 patients (44% males). Of them, 343 patients (75.4%) have raised the systolic blood pressure (SBP) immediately after the procedure. Patients who raised SBP had a significantly higher rate of the 1-year composite outcome, compared to patients who did not raise SBP following the procedure (43 [13%] vs 6 [5.4%], respectively, p=0.033). After adjustment for age and sex, the postprocedural increase in SBP was significantly associated with the composite outcome, with a hazard ratio of 2.42, 95% CI 1.03-5.7. Conclusion: An immediate increase in SBP after TAVI is associated with worse 1-year clinical cardiovascular outcomes.