AUTHOR=Zhou Zhuoming , Chen Jiantao , Fu Guangguo , Zhuang Xiaodong , Hou Jian , Chen Sida , Huang Suiqing , Yue Yuan , Shang Liqun , Wang Keke , Lv Linhua , Liang Mengya , Wu Zhongkai 

TITLE=Association of Post-operative Systolic Blood Pressure Variability With Mortality After Coronary Artery Bypass Grafting

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 8 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2021.717073

DOI=10.3389/fcvm.2021.717073

ISSN=2297-055X

ABSTRACT=Background: Blood pressure variability (BPV) has long been considered a risk factor for cardiovascular events. We aimed to investigate whether postoperative systolic BPV was associated with early and late all-cause mortality in patients undergoing coronary artery bypass grafting (CABG). 
Methods: Clinical variables and blood pressure records within the first 24 hours in the postoperative intensive care unit stay from 4509 patients operated on between 2001 and 2012 were extracted from the Medical Information Mart for Intensive Care III (MIMIC-III) database. BPV was measured as the coefficient of the variability of systolic blood pressure, and we compared patients in the highest quartile with patients in the other three quartiles. 
Results: After full adjustment, patients in the highest quartile of BPV were at a higher risk of intensive care unit mortality (OR = 2.02, 95% CI: 1.11-3.69), 30-day mortality (OR = 1.92, 95% CI: 1.22-3.02) and 90-day mortality (HR = 1.64, 95% CI: 1.19-2.27). For 2892 patients with a 4-year follow-up, the association between a higher postoperative BPV and the risk of 4-year mortality was not significant (HR = 1.17, 95% CI: 0.96-1.42). The results were supported by the comparison of survival curves and remained generally consistent in the subgroup analyses and sensitivity analyses. 
Conclusions: Our findings demonstrated that in patients undergoing CABG, a higher postoperative BPV was associated with a higher risk of early mortality while the association was not significant for late mortality. Postoperative BPV can support doctors in identifying patients with potential hemodynamic instability and making timely clinical decisions.