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<p>The current study aims to investigate the correlation between mean arterial pressure (MAP) and the risk of 28-day mortality in patients with acute myocardial infarction. This is a retrospective cohort study utilizing data from the eICU database, focusing on patients with acute myocardial infarction. We employed a multivariable logistic regression model to estimate the relationship between MAP and the 28-day mortality rate. Among 8161 patients with a median age of 67&#xa0;years, 602 (7.38%) died within 28&#xa0;days of ICU admission. Smooth curve fitting and generalized additive model analysis identified a threshold effect at MAP of 84&#xa0;mmHg. We found that when MAP is less than 84&#xa0;mmHg, a 10&#xa0;mmHg increase in MAP reduces the mortality rate by approximately 40.13%. Specifically, for every 1&#xa0;mmHg increase in MAP within this range, the mortality rate decreases significantly by 5% (OR = 0.95, 95% CI (0.93, 0.96), p &lt; 0.0001). Conversely, above the threshold (MAP ≥ 84&#xa0;mmHg), for every 10&#xa0;mmHg increase, the mortality rate increases by 34.39% (OR = 1.3439, calculated based on the fact that a 1&#xa0;mmHg MAP increase causes a 3% mortality rise (OR = 1.03, 95% CI (1.02, 1.03), p &lt; 0.0001), showing a U-shaped association between MAP and 28-day mortality. We found that the baseline MAP at ICU admission, when in the range of 57–110&#xa0;mmHg, was associated with the lowest 28-day all-cause mortality risk. The relationship between MAP and the risk of 28-day mortality forms a U-shaped curve, indicating that both higher and lower MAP levels are associated with an increased risk of 28-day mortality in ICU-admitted patients.</p>

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U shaped relationship between mean arterial pressure and 28 day mortality in ICU patients with acute myocardial infarction

  • 期刊论文

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  • 发表日期：

    2025年3月17日

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  • Qing Cui,
  • Ping Jin,
  • Yifan Ren,
  • Pei Yang,
  • Xiaoan Chen,
  • Cheng Lian

摘要

The current study aims to investigate the correlation between mean arterial pressure (MAP) and the risk of 28-day mortality in patients with acute myocardial infarction. This is a retrospective cohort study utilizing data from the eICU database, focusing on patients with acute myocardial infarction. We employed a multivariable logistic regression model to estimate the relationship between MAP and the 28-day mortality rate. Among 8161 patients with a median age of 67 years, 602 (7.38%) died within 28 days of ICU admission. Smooth curve fitting and generalized additive model analysis identified a threshold effect at MAP of 84 mmHg. We found that when MAP is less than 84 mmHg, a 10 mmHg increase in MAP reduces the mortality rate by approximately 40.13%. Specifically, for every 1 mmHg increase in MAP within this range, the mortality rate decreases significantly by 5% (OR = 0.95, 95% CI (0.93, 0.96), p < 0.0001). Conversely, above the threshold (MAP ≥ 84 mmHg), for every 10 mmHg increase, the mortality rate increases by 34.39% (OR = 1.3439, calculated based on the fact that a 1 mmHg MAP increase causes a 3% mortality rise (OR = 1.03, 95% CI (1.02, 1.03), p < 0.0001), showing a U-shaped association between MAP and 28-day mortality. We found that the baseline MAP at ICU admission, when in the range of 57–110 mmHg, was associated with the lowest 28-day all-cause mortality risk. The relationship between MAP and the risk of 28-day mortality forms a U-shaped curve, indicating that both higher and lower MAP levels are associated with an increased risk of 28-day mortality in ICU-admitted patients.