Lage en hoge bloeddruk bij ontslag na TAVI verhoogt risico op MACE

INTRODUCTION: Evidence linking pre- and post-transcatheter aortic valve implantation (TAVI) blood pressure (BP) with cardiovascular outcomes is scarce. This study investigated the associations of pre- and post-TAVI BP and their changes as a continuous variable with cardiovascular outcomes. METHODS: Patients undergoing TAVI at a tertiary university hospital between 2011 and 2025 with office BP available before and after TAVI were included. The primary outcome was a composite of major adverse cardiac events (MACE) at 1 year. Multivariable Cox proportional hazards models incorporating restricted cubic splines for continuous variables were fitted. RESULTS: Among 1191 patients, BP remained relatively stable from pre-TAVI to 1-year follow-up. Both discharge systolic BP and absolute changes therein from pre- to post-TAVI were significantly associated with MACE at 1 year (P<0.001 for both), whereas baseline systolic BP showed no significant association. BP values <115 mm Hg or >143 mm Hg were associated with a higher risk of MACE 1 year after TAVI. A decrease in systolic BP of -5 to -25 mm Hg was also associated with a lower risk of MACE compared with no change. CONCLUSIONS: While BP remains generally stable in the year following TAVI, both very low and high systolic BP at discharge were associated with higher 1-year MACE. Furthermore, moderate decreases in systolic BP from baseline to discharge appear to be protective. These findings highlight the potential prognostic value of BP optimization during TAVI follow-up and support the role of BP measurements as a clinically translatable, independently associated with long-term outcomes after TAVI.