title: Left ventricular end diastolic pressure and acute coronary syndromes.
abstract: BACKGROUND
  Data is lacking in the literature regarding the prognostic impact of left ventricular-end diastolic pressure (LVEDP) across acute coronary syndromes (ACS).
  
  
  OBJECTIVE
  To assess LVEDP and its prognostic implications in ACS patients.
  
  
  METHODS
  Prospective, longitudinal and continuous study of 1329 ACS patients from a single center between 2004 and 2006. Diastolic function was determined by LVEDP. Population was divided in two groups: A - LVEDP < 26.5 mmHg (n = 449); group B - LVEDP ≥ 26.5 mmHg (n = 226).
  
  
  RESULTS
  There were no significant differences between groups with respect to risk factors for cardiovascular disease, medical history and medical therapy during admission. In group A, patients with non-ST elevation ACS were more frequent, as well as normal coronary angiograms. In-hospital mortality was similar between groups, but one-year survival was higher in group A patients (96.9 vs 91.2%, log rank p = 0.002). On a multivariate Cox regression model, a LVEDP ≥ 26.5 mmHg (HR 2.45, 95%CI 1.05 - 5.74) remained an independent predictor for one-year mortality, when adjusted for age, LV systolic ejection fraction, ST elevation ACS, peak troponin, admission glycemia, and diuretics at 24 hours. Also, a LVEDP ≥ 26.5 mmHg was an independent predictor for a future readmission due to congestive HF (HR 6.65 95%CI 1.74 - 25.5).
  
  
  CONCLUSIONS
  In our selected population, LVEDP had a significant prognostic influence.
authors.affiliation: Departamento de Cardiologia, Hospital Universitário, Faculdade de Medicina de Coimbra, Portugal. rogeriopteixeira@gmail.com
authors.forename: Rogério
authors.initials: R
authors.lastname: Teixeira
authors.forename: Carolina
authors.initials: C
authors.lastname: Lourenço
authors.forename: Rui
authors.initials: R
authors.lastname: Baptista
authors.forename: Elisabete
authors.initials: E
authors.lastname: Jorge
authors.forename: Paulo
authors.initials: P
authors.lastname: Mendes
authors.forename: Fátima
authors.initials: F
authors.lastname: Saraiva
authors.forename: Silvia
authors.initials: S
authors.lastname: Monteiro
authors.forename: Francisco
authors.initials: F
authors.lastname: Gonçalves
authors.forename: Pedro
authors.initials: P
authors.lastname: Monteiro
authors.forename: Maria J
authors.initials: MJ
authors.lastname: Ferreira
authors.forename: Mário
authors.initials: M
authors.lastname: Freitas
authors.forename: Luís
authors.initials: L
authors.lastname: Providência
mesh_terms: D054058:Acute Coronary Syndrome / Q000401:mortality* / Q000503:physiopathology; D004812:Epidemiologic Methods; D005260:Female; D054144:Heart Failure, Diastolic / Q000175:diagnosis*; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission / Q000706:statistics & numerical data; D011379:Prognosis; D012016:Reference Values; D013318:Stroke Volume / Q000502:physiology*; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis*