Department of Cardiac Surgery, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
Department of Cardiothoracic Surgical ICU, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
J Cardiovasc Transl Res. 2024 Apr;17(2):287-297. doi: 10.1007/s12265-023-10475-6. Epub 2024 Jan 9.
Blood pressure dipping patterns have long been considered to be associated with adverse events. We aimed to investigate whether dipping patterns of postoperative MAP were related to 90-day and hospital mortality in patients undergoing CABG. Four thousand three hundred ninety-one patients were classified into extreme dippers (night-to-day ratio of MAP ≤ 0.8), dippers (0.8 < night-to-day ratio of MAP ≤ 0.9), non-dippers (0.9 < night-to-day ratio of MAP ≤ 1), and reverse dippers (> 1). Compared with non-dippers, reverse dippers were at a higher risk of 90-day mortality (aHR = 1.58; 95% CI, 1.10-2.27) and hospital mortality (aOR = 1.97; 95% CI, 1.12-3.47). A significant interaction was observed between hypertension and dipping patterns (P for interaction = 0.02), with a significant increased risk of 90-day mortality in non-hypertensive reverse dippers (aHR = 1.90; 95% CI, 1.17-3.07) but not in hypertensive reverse dippers (aHR = 1.26; 95% CI, 0.73-2.19).
血压变异性模式长期以来一直被认为与不良事件有关。我们旨在研究 CABG 术后 MAP 的变异性模式是否与 90 天和住院死亡率相关。将 4391 名患者分为极度变异性（MAP 的夜间/日间比值≤0.8）、变异性（0.8＜MAP 的夜间/日间比值≤0.9）、非变异性（0.9＜MAP 的夜间/日间比值≤1）和反变异性（＞1）。与非变异性相比，反变异性者 90 天死亡率（aHR=1.58；95%CI，1.10-2.27）和住院死亡率（aOR=1.97；95%CI，1.12-3.47）的风险更高。高血压和变异性模式之间存在显著的交互作用（P 交互=0.02），非高血压反变异性者 90 天死亡率的风险显著增加（aHR=1.90；95%CI，1.17-3.07），但高血压反变异性者的风险没有显著增加（aHR=1.26；95%CI，0.73-2.19）。
