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Association between inter-leg blood pressure difference and cardiovascular outcome in patients undergoing
Inki Moon1, Hack-Lyoung Kim2, Woo-Hyun Lim2
1Division of Cardiology, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea.
Insights
The inter-leg systolic blood pressure difference, but not the inter-arm difference, predicts major adverse cardiovascular events in patients after percutaneous coronary intervention. This simple measurement can aid in risk stratification for these patients.
Area of Science:
- Cardiology
- Vascular Medicine
- Clinical Risk Assessment
Background:
- Inter-arm blood pressure (BP) difference is linked to cardiovascular events.
- The prognostic significance of inter-leg BP difference remains unclear.
- This study investigates the prognostic value of inter-arm and inter-leg BP differences in patients undergoing percutaneous coronary intervention (PCI).
Purpose of the Study:
- To determine if inter-arm and inter-leg BP differences predict major adverse cardiovascular events (MACE) in patients post-PCI.
- To assess the independent prognostic value of these BP differences in a PCI patient cohort.
Main Methods:
- A prospective study enrolled 667 patients undergoing PCI.
- Arm and leg BPs were measured the day after PCI.
- Major adverse cardiovascular events (MACE) were tracked over a 3-year follow-up period.
Main Results:
- Increased inter-leg systolic BP difference (ILSBPD) was significantly higher in patients who experienced MACE.
- ILSBPD was independently associated with an increased risk of MACE (HR 1.07 per 5 mmHg).
- Inter-arm systolic BP difference showed no significant association with MACE.
Conclusions:
- Elevated ILSBPD is an independent predictor of worse cardiovascular outcomes after PCI.
- ILSBPD is a simple and potentially valuable tool for risk stratification in PCI patients.
Background:
Although the inter-arm blood pressure (BP) difference has been advocated to be associated with cardiovascular events, the implication of inter-leg BP difference has not been well established. This study was conducted to investigate whether inter-arm and -leg BP differences have prognostic value in patients undergoing percutaneous coronary intervention (PCI).
Methods:
In this prospective study, we consecutively enrolled 667 patients who underwent PCI. Both arm and leg BPs were measured at the day after PCI. The primary outcome was a major adverse cardiovascular event (MACE) including cardiac death, acute coronary syndrome, coronary revascularization, stroke, and hospitalization for heart failure during the follow-up period.
Results:
Mean age was 64.0±11.1 years old, and males were predominant (70.5%). During a mean follow-up period of 3.0 years, MACE occurred in 209 (31.3%) patients. The inter-leg systolic BP difference (ILSBPD) was significantly higher in patients with MACE than those without (9.9±12.3 vs. 7.2±7.5 mmHg, P = 0.004). The inter-arm systolic BP difference was not significantly different between patients with and without MACE (P = 0.403). In multivariable Cox regression analysis, increased ILSBPD was independently associated with the development of MACE (per 5 mmHg; hazard ratio, 1.07; 95% confidence interval, 1.01-1.14). The inter-arm systolic BP difference was not associated with MACE in the multivariable analysis.
Conclusion:
Increased ILSBPD was independently associated with worse cardiovascular outcomes after PCI. As ILSBPD is easy to measure, it may be helpful in the risk stratification of patients undergoing PCI.
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