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Do Cardiovascular Risk Factors and Severity and Complexity of Coronary Atherosclerosis Predict Aortic Pulse Pressure

Hemal Bhatt1, Dharmesh Sanghani2, George Apergis2

  • 1Division of Cardiovascular Medicine, University of Alabama at Birmingham, Birmingham, Alabama.

The International Journal of Angiology : Official Publication of the International College of Angiology, Inc
|May 28, 2016
PubMed

Insights

Aortic pulse pressure (PP) is linked to cardiovascular events. This study found aging, aspirin use, and declining kidney function predict higher aortic PP, but not coronary artery disease severity.

Area of Science:

  • Cardiovascular Medicine
  • Nephrology
  • Geriatrics

Background:

  • Pulse pressure (PP), particularly aortic PP, is associated with adverse cardiovascular outcomes.
  • However, its relationship with cardiovascular risk factors and the severity of coronary artery disease (CAD) remains understudied.
  • Invasive measurement of aortic PP provides a direct assessment, distinct from peripheral estimations.

Purpose of the Study:

  • To identify predictors of invasively measured aortic pulse pressure in patients undergoing cardiac catheterization.
  • To investigate the association between aortic pulse pressure and cardiovascular risk factors.
  • To determine if aortic pulse pressure correlates with the severity and complexity of coronary atherosclerosis.

Main Methods:

  • Retrospective review of electronic medical records from 368 patients between 2010 and 2013.
  • Data collection included demographics, cardiovascular risk factors, coronary lesion characteristics, and medication use.
  • Multivariable regression analysis was used to identify predictive factors for aortic pulse pressure.

Main Results:

  • Aging (β=0.34, p=0.001) and prior aspirin use (β=5.09, p=0.015) were significantly associated with higher aortic pulse pressure.
  • Increasing estimated glomerular filtration rate (eGFR) (β=-0.52, p=0.040) was associated with lower aortic pulse pressure, indicating declining renal function predicts higher PP.
  • No significant association was found between aortic pulse pressure and the severity or complexity of coronary lesions (e.g., SYNTAX score, number of obstructed vessels).

Conclusions:

  • Aortic pulse pressure is predicted by age, prior aspirin use, and declining renal function.
  • Elevated aortic pulse pressure may not be mediated by the severity of coronary atherosclerosis.
  • Further research is needed to understand the mechanisms linking aortic PP to cardiovascular events independently of CAD severity.

Keywords:
SYNTAX scoreagingaortic pulse pressureaspirinatherosclerosiscardiac catheterizationcardiovascular risk factorscoronary artery disease

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