PMID- 31840441 OWN - NLM STAT- MEDLINE DCOM- 20210526 LR - 20210526 IS - 2055-5822 (Electronic) IS - 2055-5822 (Linking) VI - 7 IP - 1 DP - 2020 Feb TI - Systolic blood pressure, heart rate, and outcomes in patients with coronary disease and heart failure. PG - 123-129 LID - 10.1002/ehf2.12534 [doi] AB - AIMS: Data regarding the optimal systolic blood pressure (SBP) and heart rate (HR) for coronary artery disease (CAD) patients with hypertension and a history of heart failure (HF) are limited. Accordingly, using data from a large clinical trial, we investigated the association between SBP and heart rate and subsequent adverse outcomes in CAD patients with a history of HF, and we aimed to better understand how pre-existing HF impacts outcomes among patients with CAD. METHODS AND RESULTS: Among 22 576 CAD patients enrolled in the INternational VErapamil SR-Trandolapril STudy (INVEST), 1256 were identified with a history of physician-diagnosed HF New York Heart Association (NYHA) Class 1-3 at entry. The primary outcome was the first occurrence of all-cause death, myocardial infarction (MI), or stroke. Cox proportional-hazards models adjusted for pre-specified covariates were constructed to estimate risk among the HF cohort compared with a case-matched sample from the non-HF cohort. At a mean 2.5 years' follow-up, those with prior HF had a higher risk of the primary outcome (hazard ratio (HR) 2.55, 95% confidence interval 2.30-2.83, P < 0.0001). Among those with history of HF, a low (<120 mmHg) or high (>140 mmHg) SBP and heart rate >/= 85 b.p.m. were associated with increased risk for adverse outcomes, which persisted after covariate adjustment. CONCLUSIONS: In patients with CAD, a physician diagnosis of HF at baseline portended a higher risk for death, MI, or stroke than in those without an HF history. Achieving SBP of 120-140 mmHg and heart rate < 85 b.p.m. was associated with a better outcome in patients with known HF and CAD. CI - (c) 2019 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology. FAU - Elgendy, Islam Y AU - Elgendy IY AD - Division of Cardiovascular Medicine, Department of Medicine, University of Florida, Gainesville, FL, USA. AD - Division of Cardiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA. FAU - Hill, James A AU - Hill JA AD - Division of Cardiovascular Medicine, Department of Medicine, University of Florida, Gainesville, FL, USA. FAU - Szady, Anita D AU - Szady AD AD - Division of Cardiovascular Medicine, Department of Medicine, University of Florida, Gainesville, FL, USA. AD - Cardiovascular Center of Marin, MarinHealth, Larkspur, CA, USA. FAU - Gong, Yan AU - Gong Y AD - Department of Pharmacotherapy and Translational Research, University of Florida, Gainesville, FL, USA. FAU - Cooper-DeHoff, Rhonda M AU - Cooper-DeHoff RM AD - Division of Cardiovascular Medicine, Department of Medicine, University of Florida, Gainesville, FL, USA. AD - Department of Pharmacotherapy and Translational Research, University of Florida, Gainesville, FL, USA. FAU - Pepine, Carl J AU - Pepine CJ AD - Division of Cardiovascular Medicine, Department of Medicine, University of Florida, Gainesville, FL, USA. LA - eng GR - W81XWH-17-2-0030/U.S. Department of Defense/International GR - Gatorade Trust/International GR - K23 HL086558/HL/NHLBI NIH HHS/United States GR - R01 HL132448/HL/NHLBI NIH HHS/United States GR - UL1 TR001427/TR/NCATS NIH HHS/United States GR - R01 HL033610/HL/NHLBI NIH HHS/United States GR - CDRN-1501-26692/PCORnet-OneFlorida Clinical Research Consortium/International PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't PT - Research Support, U.S. Gov't, Non-P.H.S. DEP - 20191215 PL - England TA - ESC Heart Fail JT - ESC heart failure JID - 101669191 RN - 0 (Antihypertensive Agents) SB - IM MH - Aged MH - Antihypertensive Agents/therapeutic use MH - *Blood Pressure MH - *Coronary Artery Disease/complications/diagnosis/epidemiology MH - Female MH - *Heart Failure/drug therapy/epidemiology MH - *Heart Rate MH - Humans MH - Male MH - Middle Aged MH - *Percutaneous Coronary Intervention PMC - PMC7083485 OTO - NOTNLM OT - Blood pressure OT - Coronary artery disease OT - Heart failure OT - Hypertension COIS- RMC reports receiving research funding from Abbott Laboratories while INVEST was being conducted. CJP reports grant support (significant) from Adelphi Values (Qualitative MVA), Amorcyte (PreSERVE), Athersys (MI-NSTEMI), BioCardia (CardiAMP), Brigham and Women's Hospital (INVESTED), Capricor (ALLSTAR), Cytori Therapeutics (ATHENA), Duke University (ADAPTABLE), Gilead Sciences, Inc. (RWISE, University of Florida site), Merck & Co., Inc. (VICTORIA), Mesoblast (TEVA, University of Florida site), NIH/NHLBI (CONCERT), US Department of Defense (WARRIOR), and Ventrix (CV-201); and educational support (modest) for the Vascular Biology Working Group from Amgen Inc., AstraZeneca Pharmaceuticals, Boehringer Ingelheim Pharmaceuticals Inc., Daiichi Sankyo, Ionis, and Relypsa; consultant fees/honoraria (modest) from Amgen Inc., AstraZeneca Pharmaceuticals, Bayer Healthcare Pharmaceuticals, Gilead, Merck and (significant) from Ironwood Pharmaceuticals Inc., and SLACK Inc.; and is a task force member (no compensation) of FACT: Foundation for the Accreditation of Cellular Therapy. IYE, JAH, ADS, and YG report that they have nothing to disclose. EDAT- 2019/12/17 06:00 MHDA- 2021/05/27 06:00 PMCR- 2019/12/15 CRDT- 2019/12/17 06:00 PHST- 2019/04/08 00:00 [received] PHST- 2019/07/08 00:00 [revised] PHST- 2019/09/17 00:00 [accepted] PHST- 2019/12/17 06:00 [pubmed] PHST- 2021/05/27 06:00 [medline] PHST- 2019/12/17 06:00 [entrez] PHST- 2019/12/15 00:00 [pmc-release] AID - EHF212534 [pii] AID - 10.1002/ehf2.12534 [doi] PST - ppublish SO - ESC Heart Fail. 2020 Feb;7(1):123-129. doi: 10.1002/ehf2.12534. Epub 2019 Dec 15.