Abstract / Summary
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.