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Change in pulse pressure and cardiovascular outcomes after percutaneous coronary intervention: The CLIDAS study

Kotaro Nochioka1, Masaharu Nakayama2, Naoyuki Akashi3

  • 1Division of Cardiovascular Medicine, Tohoku University Hospital, Seiryo-machi 1-1, Aoba-ku, Sendai 981-0933, Japan.

International Journal of Cardiology. Heart & Vasculature
|September 4, 2024
PubMed

Insights

Changes in pulse pressure (PP) during hospitalization after percutaneous coronary intervention (PCI) show a U-shaped association with cardiovascular outcomes. Careful blood pressure management is crucial for patients post-PCI.

Area of Science:

  • Cardiology
  • Vascular Medicine
  • Clinical Outcomes Research

Background:

  • Limited data exist on the prognostic value of pulse pressure (PP) changes during hospitalization for patients with coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI).
  • Understanding these changes is crucial for optimizing patient care and predicting cardiovascular events post-PCI.

Purpose of the Study:

  • To examine the association between discharge pulse pressure (PP) and cardiovascular outcomes in patients who underwent PCI.
  • To investigate the prognostic value of PP changes during hospitalization in this patient cohort.

Main Methods:

  • A retrospective study of 8,708 patients who underwent PCI was conducted using the Clinical Deep Data Accumulation System (CLIDAS).
  • Pulse pressure (PP) was measured before PCI and at discharge, with patients categorized into quintiles based on PP change.
  • Major adverse cardiac or cerebrovascular events (MACCE), revascularization, and heart failure (HF) hospitalization were analyzed in relation to PP and its changes.

Main Results:

  • A U-shaped relationship was observed between PP changes and the incidence of MACCE, revascularization, and HF hospitalization.
  • Higher discharge PP was associated with an increased risk of MACCE (adjusted hazard ratio 1.41 in the highest quintile).
  • Both significant decreases (Q1) and increases (Q5) in PP were linked to higher MACCE risk, indicating a U-shaped association.

Conclusions:

  • The study demonstrates a significant U-shaped association between pulse pressure (PP) changes during hospitalization and cardiovascular outcomes in patients post-PCI.
  • These findings highlight the importance of monitoring and managing blood pressure, specifically PP, during hospitalization for patients undergoing PCI to improve clinical outcomes.
Abstract

Keywords:
Coronary artery diseasePrognosisPulse pressure

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