TCT-661 Impact of Pre-Procedural Blood Pressure on Long-term Outcomes Following Percutaneous Coronary Intervention

Warren, Josephine; Nanayakkara, Shane; Andrianopoulos, Nick; Brennan, A.; Selkrig, L.; Dart, Anthony M.; Clark, David; Hiew, C.; Freeman, Melanie; Kingwell, Bronwyn A.; Duffy, Stephen W.

doi:10.1016/j.jacc.2017.09.909

Cited by 4 publications

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“…Globally, increased PP is related to higher large artery stiffness which leads to an increase in SBP and a decrease in DBP. Increased PP has been reported to be associated with mortality or adverse outcomes in general population, 2–4 hypertensive patients, 5 myocardial infarction patients, 6,7 patients with atherothrombosis, 8 and patients undergoing percutaneous coronary intervention (PCI) 9 . The previous studies also reported the inversely relationship between PP level and adverse outcomes in patients with heart failure (HF), 10,11 and acute coronary syndrome (ACS) 12,13 .…”

Section: Introductionmentioning

confidence: 99%

The U‐shape relationship between pulse pressure level on inpatient admission and long‐term mortality in acute coronary syndrome patients undergoing percutaneous coronary intervention

Huang

Ying

et al. 2021

J of Clinical Hypertension

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The association between pulse pressure and long‐term mortality was investigated among acute coronary syndrome (ACS) patients who received percutaneous coronary intervention (PCI). The study population included 5055 ACS patients in the Department of Cardiology of Beijing Friendship Hospital who were enrolled from January 2013 to July 2019. The median duration of follow‐up was 24 months. Multivariate Cox regression was used to analyze the relationships between PP on inpatient admission and mortalities. Non‐linear associations were studied by restricted cubic splines. Considering the heart function, the analyses were performed in the whole cohort and the LVEF > = 0.5 cohort separately. Subgroup analyses were performed according to the different diagnosis (the myocardial infarction subgroup and the unstable angina pectoris subgroup). When PP was used as categorical variable, the high PP group (≥61 mm Hg) significantly increased the risk of death compared with the intermediate PP group (50–60 mm Hg) in the both cohorts. When PP was used as continuous variable, a U‐shape relationship were found between PP and mortalities in the whole cohort ( p (for nonlinearity) = .005 and .003, respectively), with reference PP level of 55 mm Hg. However, this U‐shape relationship disappeared in the LVEF > 0.5 cohort ( p (for nonlinearity) = .111 and .117, respectively). The similar results were obtained in MI subgroup. From this study, the U‐shape relationships between PP level and all‐cause and cardiac mortalities were found in ACS patients who underwent PCI. The U‐shape relationships disappeared in the LVEF > 0.5 cohort. The reference PP level was 55 mm Hg.

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Section: Introductionmentioning

confidence: 99%

The U‐shape relationship between pulse pressure level on inpatient admission and long‐term mortality in acute coronary syndrome patients undergoing percutaneous coronary intervention

Huang

Ying

et al. 2021

J of Clinical Hypertension

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“…Moreover, wide PP is an independent predictor of extensive cardiovascular disease 12–14 . Taking an individual's SBP and DBP into consideration, wide PP patients can divide into three types of low SBP and low DBP (LSLD), high SBP and low DBP (HSLD), and high SBP and high DBP (HSHD) 15 . The antihypertensive treatment has focused on SBP only for a long time.…”

Section: Introductionmentioning

confidence: 99%

“…[12][13][14] Taking an individual's SBP and DBP into consideration, wide PP patients can divide into three types of low SBP and low DBP (LSLD), high SBP and low DBP (HSLD), and high SBP and high DBP (HSHD). 15 The antihypertensive treatment has focused on SBP only for a long time. However, PP can better reflect cardiovascular status in the elderly population due to the blood pressure characteristics of changing with increasing age.…”

Section: Introductionmentioning

confidence: 99%

Influencing factors of wide pulse pressure in an elderly Chinese population: A cross‐sectional study

Yang

Chen

Zhang

et al. 2022

J of Clinical Hypertension

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Blood pressure and pulse pressure (PP) had their own characteristics in the elderly population. This cross‐sectional study including 5030 elderly participants was conducted to describe the distribution of blood pressure and wide PP in the elderly population and find influencing factors of wide PP. Wide PP was defined as PP equal to or more than 65 mmHg, and was classified three types as low systolic blood pressure (SBP) and low diastolic blood pressure (DBP) (LSLD), high SBP and low DBP (HSLD), and high SBP and high DBP (HSHD). Using multivariate logistic regression models to analyze the associations of demographic factors, health‐related factors and lifestyle factors with different wide PP types. The associations of lifestyles with wide PP by gender were estimated by subgroup analyses. Among 5030 elderly participants, 2727 (54.2%) participants had wide PP. Logistic regression models showed older age (OR = 2.48, 95%CI: 2.14‐2.88), female (OR = 1.31, 95%CI: 1.07‐1.60), not married (OR = 1.26, 95%CI: 1.07‐1.49), having chronic diseases (OR = 1.28, 95%CI: 1.09‐1.50), current alcohol drinker (OR = 1.29, 95%CI: 1.11‐1.50) were positively associated, and higher body height (OR = .78, 95%CI: .62‐.99), higher education level (OR = .60, 95%CI: .43‐.82), current smoker (OR = .79, 95%CI: .64‐.97) were negatively associated with wide PP. Among three different types of wide PP including LSLD, HSLD, HSHD, these factors had different effects. Subgroup analyses found that only among male, current smoker was negatively associated and current alcohol drinker was positively associated with wide PP.

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“…The optimal target for DBP in patients undergoing percutaneous coronary intervention (PCI) is not known. The combination of a high SBP and a low DBP (ie, a widened pulse pressure) before PCI has previously been demonstrated to confer a higher long-term risk of mortality 8 when compared with a narrow pulse pressure, but the effect of DBP in isolation has not previously been examined. We, therefore, sought to examine the impact of low DBP in patients with CAD undergoing PCI with well-controlled SBP (<140 mm Hg).…”

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confidence: 99%

Impact of Preprocedural Diastolic Blood Pressure on Outcomes in Patients Undergoing Percutaneous Coronary Intervention

Warren,

Dinh,

Brennan

et al. 2023

Hypertension

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Background: Recent US guidelines recommend lower blood pressure (BP) targets in hypertension, but aggressive lowering of diastolic BP (DBP) can occur at the expense of myocardial perfusion, particularly in the presence of coronary artery disease. We sought to establish the long-term impact of low DBP on mortality among patients undergoing percutaneous coronary intervention with well-controlled systolic BP. Methods: We analyzed data from 12 965 patients undergoing percutaneous coronary intervention between 2009 and 2018 from the Melbourne Interventional Group registry who had a preprocedural systolic BP of ≤140 mm Hg. Patients with ST-elevation myocardial infarction, cardiogenic shock, and out-of-hospital arrest were excluded. Patients were stratified into 5 groups according to preprocedural DBP: <50, 50 to 59, 60 to 69, 70 to 79, and ≥80 mm Hg. The primary outcome was long-term, all-cause mortality. Mortality data were derived from the Australian National Death Index. Results: Patients with DBP<50 mm Hg were older with higher rates of diabetes, renal impairment, prior myocardial infarction, left ventricular dysfunction, peripheral and cerebrovascular disease (all P <0.001). Patients with DBP<50 mm Hg had higher 30-day (2.5% versus 0.7% for the other 4 quintiles; P <0.0001) and long-term mortality (median, 3.6 years; follow-up, 29% versus 11%; P <0.0001). Cox-regression analysis revealed that DBP<50 mm Hg was an independent predictor of long-term mortality (HR, 1.55 [95% CI, 1.20–2.00]; P =0.001). Conclusions: In patients with well-controlled systolic BP undergoing percutaneous coronary intervention, low DBP (<50 mm Hg) is an independent predictor of long-term mortality.

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TCT-661 Impact of Pre-Procedural Blood Pressure on Long-term Outcomes Following Percutaneous Coronary Intervention

Cited by 4 publications

References 0 publications

The U‐shape relationship between pulse pressure level on inpatient admission and long‐term mortality in acute coronary syndrome patients undergoing percutaneous coronary intervention

The U‐shape relationship between pulse pressure level on inpatient admission and long‐term mortality in acute coronary syndrome patients undergoing percutaneous coronary intervention

Influencing factors of wide pulse pressure in an elderly Chinese population: A cross‐sectional study

Impact of Preprocedural Diastolic Blood Pressure on Outcomes in Patients Undergoing Percutaneous Coronary Intervention

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