Impact of Pre-Procedural Blood Pressure on Long-Term Outcomes Following Percutaneous Coronary Intervention

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  • Additional Information
    • Affiliation:
      a Alfred Hospital, Melbourne, Victoria, Australia
      b Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
      c Department of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
      d Centre of Cardiovascular Research and Education in Therapeutics, Monash University, Melbourne, Victoria, Australia
      e Austin Hospital, Melbourne, Victoria, Australia
      f Royal Melbourne Hospital, Melbourne, Victoria, Australia
      g Geelong Hospital, Geelong, Victoria, Australia
      h Box Hill Hospital, Melbourne, Victoria, Australia
    • Note:
      The Melbourne Interventional Group has received unrestricted educational grant funding from Abbott Vascular, AstraZeneca, Medtronic, Merck Sharp & Dohme, Pfizer, Servier, and The Medicines Company. These companies do not have access to the data, and do not have the right to review manuscripts before publication. Dr Nanayakkara is supported by a Heart Foundation Health Professional Scholarship and a Baker Bright Sparks scholarship. Dr. Yudi is supported by a combined National Health and Medical Research Council and National Heart Foundation Postgraduate Scholarship. Prof. Reid’s and Prof. Duffy’s work is funded by National Health and Medical Research Council of Australia Grants. Dr. Kingwell has research grant contracts with CSL Ltd. that are unrelated to the current publication. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. George Bakris, MD, served as Guest Associate Editor for this paper. A full list of the Melbourne Interventional Group Investigators can be found in the Online Appendix.
      Listen to this manuscript's audio summary by Editor-in-Chief Dr. Valentin FusteronJACC.org.
    • Keywords:
      blood pressure
      coronary artery disease
      outcomes
      percutaneous coronary intervention
      pulse pressure
    • Abstract:
      Background High systolic blood pressure (SBP) increases cardiac afterload, whereas low diastolic blood pressure (DBP) may lead to impaired coronary perfusion. Thus, wide pulse pressure (high systolic, low diastolic [HSLD]) may contribute to myocardial ischemia and also be a predictor of adverse cardiovascular events.
    • Abstract:
      Methods The study included 10,876 consecutive patients between August 2009 and December 2016 from the Melbourne Interventional Group registry undergoing PCI with pre-procedural blood pressure recorded. Patients with ST-segment elevation myocardial infarction, cardiogenic shock, and out-of-hospital cardiac arrest were excluded. Patients were divided into 4 groups according to SBP (high ≥120 mm Hg, low <120 mm Hg) and DBP (high >70 mm Hg, low ≤70 mm Hg).
    • Abstract:
      Results Mean pulse pressure was 60 ± 21 mm Hg. Patients with HSLD were older and more frequently women, with higher rates of hypercholesterolemia, renal impairment, diabetes, and multivessel and left main disease (all p ≤ 0.0001). There was no difference in 30-day major adverse cardiac events, but at 12 months the HSLD group had a greater incidence of myocardial infarction (p = 0.018) and stroke (p = 0.013). Long-term mortality was highest for HSLD (7.9%) and lowest for low systolic, high diastolic (narrow pulse pressure) at 2.1% (p = 0.0002). Cox regression analysis demonstrated significantly lower long-term mortality in the low systolic, high diastolic cohort (hazard ratio: 0.50; 99% confidence interval: 0.25 to 0.98; p = 0.04).
    • Abstract:
      Conclusions Pulse pressure at the time of index PCI is associated with long-term outcomes following PCI. A wide pulse pressure may serve as a surrogate marker for risk following PCI and represents a potential target for future therapies.
    • Abstract:
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    • ISSN:
      0735-1097
    • Accession Number:
      10.1016/j.jacc.2019.03.493
    • Accession Number:
      S0735109719347862
    • Copyright:
      © 2019 the American College of Cardiology Foundation. Published by Elsevier. All rights reserved.
  • Citations
    • ABNT:
      REID, C. et al. Impact of Pre-Procedural Blood Pressure on Long-Term Outcomes Following Percutaneous Coronary Intervention. Journal of the American College of Cardiology, [s. l.], v. 73, n. 22, p. 2846–2855, 2019. DOI 10.1016/j.jacc.2019.03.493. Disponível em: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=edselp&AN=S0735109719347862. Acesso em: 1 dez. 2020.
    • AMA:
      Reid C, Andrianopoulos N, Brennan A, et al. Impact of Pre-Procedural Blood Pressure on Long-Term Outcomes Following Percutaneous Coronary Intervention. Journal of the American College of Cardiology. 2019;73(22):2846-2855. doi:10.1016/j.jacc.2019.03.493
    • APA:
      Reid, C., Andrianopoulos, N., Brennan, A., Dinh, D., Reid, C., Ajani, A., Duffy, S., Clark, D., Freeman, M., Hiew, C., Andrianopoulos, N., Oqueli, E., Brennan, A., Duffy, S. J., Shaw, J. A., Walton, A., Dart, A., Broughton, A., Federman, J., … Duffy, S. J. (2019). Impact of Pre-Procedural Blood Pressure on Long-Term Outcomes Following Percutaneous Coronary Intervention. Journal of the American College of Cardiology, 73(22), 2846–2855. https://doi.org/10.1016/j.jacc.2019.03.493
    • Chicago/Turabian: Author-Date:
      Reid, Chris, Nick Andrianopoulos, Angela Brennan, Diem Dinh, Chris Reid, Andrew Ajani, Stephen Duffy, et al. 2019. “Impact of Pre-Procedural Blood Pressure on Long-Term Outcomes Following Percutaneous Coronary Intervention.” Journal of the American College of Cardiology 73 (22): 2846–55. doi:10.1016/j.jacc.2019.03.493.
    • Harvard:
      Reid, C. et al. (2019) ‘Impact of Pre-Procedural Blood Pressure on Long-Term Outcomes Following Percutaneous Coronary Intervention’, Journal of the American College of Cardiology, 73(22), pp. 2846–2855. doi: 10.1016/j.jacc.2019.03.493.
    • Harvard: Australian:
      Reid, Chris, Andrianopoulos, Nick, Brennan, A, Dinh, Diem, Reid, Chris, Ajani, A, Duffy, S, Clark, D, Freeman, Melanie, Hiew, Chin, Andrianopoulos, Nick, Oqueli, Ernesto, Brennan, A, Duffy, S.J., Shaw, JA, Walton, A, Dart, A, Broughton, A, Federman, J, Keighley, C, Hengel, C, Peter, KH, Stub, D, Chan, W, Warren, J., O, BJ, Selkrig, L, Huntington, R, Clark, DJ, Farouque, O, Horrigan, M, Johns, J, Oliver, L, Brennan, J, Chan, R, Proimos, G, Dortimer, T, Chan, B, Nadurata, V, Huq, R, Fernando, D, Al-Fiadh, A, Yudi, M, Sugumar, H, Ramchand, J, Han, H, Picardo, S, Brown, L, Oqueli, E., Hengel, C, Sharma, A, Zhu, B, Ryan, N, Harrison, T, New, G, Roberts, L, Freeman, M., Rowe, M, Proimos, G, Cheong, Y, Goods, C, Fernando, D, Teh, A, Parfrey, S, Ramzy, J, Koshy, A, Venkataraman, P, Flannery, D, Hiew, C., Sebastian, M, Yip, T, Mok, M, Jaworski, C, Hutchinson, A, Cimenkaya, C, Ngu, P, Khialani, B, Salehi, H, Turner, M, Dyson, J, McDonald, B, Van Den Nouwelant, D, Halliburton, K, Reid, C., Andrianopoulos, N., Brennan, AL, Dinh, D., Yan, BP, Ajani, AE, Warren, R, Eccleston, D, Lefkovits, J, Iyer, R, Gurvitch, R, Wilson, W, Brooks, M, Biswas, S, Yeoh, J, Warren, Josephine, et al. 2019, ‘Impact of Pre-Procedural Blood Pressure on Long-Term Outcomes Following Percutaneous Coronary Intervention’, Journal of the American College of Cardiology, vol. 73, no. 22, pp. 2846–2855, viewed 1 December 2020, .
    • MLA:
      Reid, Chris, et al. “Impact of Pre-Procedural Blood Pressure on Long-Term Outcomes Following Percutaneous Coronary Intervention.” Journal of the American College of Cardiology, vol. 73, no. 22, June 2019, pp. 2846–2855. EBSCOhost, doi:10.1016/j.jacc.2019.03.493.
    • Chicago/Turabian: Humanities:
      Reid, Chris, Nick Andrianopoulos, Angela Brennan, Diem Dinh, Chris Reid, Andrew Ajani, Stephen Duffy, et al. “Impact of Pre-Procedural Blood Pressure on Long-Term Outcomes Following Percutaneous Coronary Intervention.” Journal of the American College of Cardiology 73, no. 22 (June 11, 2019): 2846–55. doi:10.1016/j.jacc.2019.03.493.
    • Vancouver/ICMJE:
      Reid C, Andrianopoulos N, Brennan A, Dinh D, Reid C, Ajani A, et al. Impact of Pre-Procedural Blood Pressure on Long-Term Outcomes Following Percutaneous Coronary Intervention. Journal of the American College of Cardiology [Internet]. 2019 Jun 11 [cited 2020 Dec 1];73(22):2846–55. Available from: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=edselp&AN=S0735109719347862