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

*geplaatst 2026-10-19 · Algemeen · Journal of the American Heart Association · doi 10.1161/JAHA.126.050999 · https://hartvaat.nl/2026/10/10/lage-en-hoge-bloeddruk-bij-ontslag-na-tavi-verhoogt-risico-op-mace/*

In een cohort van 1191 patiënten die een TAVI ondergingen, bleek de systolische bloeddruk bij ontslag en de absolute verandering ten opzichte van de baseline significant geassocieerd te zijn met een samengesteld eindpunt van MACE na één jaar. Een U-vormig verband werd gevonden: waarden onder de 115 mmHg of boven de 143 mmHg gingen gepaard met een hoger risico, terwijl een matige daling van 5 tot 25 mmHg beschermend werkte. Deze bevindingen benadrukken het prognostische belang van bloeddrukoptimalisatie tijdens het TAVI-nazorgtraject en ondersteunen het routinematig meten van de bloeddruk bij ontslag.

## English: Impact of Continuous Baseline and Discharge Blood Pressure on Outcomes After Transcatheter Aortic Valve Implantation.

In a single-center cohort of 1,191 patients undergoing TAVI, discharge systolic blood pressure and its change from baseline were significantly associated with 1-year major adverse cardiac events. A U-shaped relationship was observed, with risks increasing when discharge BP fell below 115 mmHg or exceeded 143 mmHg, whereas a moderate reduction of 5 to 25 mmHg was protective. These findings highlight the prognostic value of optimizing blood pressure at hospital discharge and support routine BP monitoring as a simple, translatable tool for risk stratification after TAVI.

## Abstract (original, from the publication)

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.

Auteurs: Thorald Stolte, Jakob Johannes Reichl, Felix Goetzinger, Max Wagener, Ketina Arslani, Anke von Peter, Rahel Berger, Christoph Kaiser, Michael Böhm, Lucas Lauder, Felix Mahfoud, Thomas Nestelberger

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Bron: Journal of the American Heart Association, https://doi.org/10.1161/JAHA.126.050999. Bijgewerkt 2026-10-12T01:12:47Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.