Effect of inter-arm blood pressure differences on outcomes after percutaneous coronary intervention. Issue 6 (June 2020)

• Record Type: Journal Article
• Authors: Park, Se-Jun; Son, Jung-Woo; Hong, Kyung-Soon; Choi, Hyun-Hee
• Is Part Of: Journal of cardiology. Volume 75:Issue 6(2020)
• Page Start: 648
• Page End: 653
• Publication Date: 2020-06
• Subjects: Inter-arm blood pressure difference -- Percutaneous coronary intervention -- Drug-eluting stent; Cardiology -- Periodicals; 616.12
• DOI: 10.1016/j.jjcc.2019.12.014
• Languages: English
• ISSNs: 0914-5087

Abstract

Highlights: Inter-arm blood pressure difference (IABPD) is a non-invasive parameter associated with cardiovascular disease. A higher IABPD was related with the adverse outcomes of percutaneous coronary intervention-treated patients. Especially, the risk of ischemia-driven target vessel revascularization was increased in a higher IABPD. IABPD is useful and feasible for predicting cardiovascular outcomes. Abstract: Background: We investigated the effect of inter-arm blood pressure differences (IABPD) on the percutaneous coronary intervention (PCI) outcomes of patients with coronary artery diseases. Methods: We retrospectively reviewed the data of blood pressures measured simultaneously in the bilateral arms of 855 patients (560 males) who underwent PCI with drug-eluting stents for coronary artery diseases. IABPD was defined as the difference of blood pressure in both arms. The primary outcome was the presence of major adverse cardiac events (MACE) consisting of cardiovascular death, myocardial infarction, stroke, and ischemia-driven target vessel revascularization. Results: The mean age of the included patients was 66.2 ± 11.6 years, with a mean follow-up period of 44.5 ± 26.4 months. MACE occurred in 15.2% of patients, showing a higher rate in the higher IABPD group (≥10 mmHg) than in the lower IABPD group (<10 mmHg) (22.5% vs 14.5%, p = 0.081). The difference was induced by a higher rate of ischemia-driven target vessel revascularization (17.5% vs 8.3%, p = 0.011). The Kaplan-Meier survival analysis revealed a greater incidence of MACE in patients with a higher IABPD (log rank p = 0.054). The Cox proportional hazard analysis showed that IABPD was an independent predictor of long-term MACE (hazard ratio, 1.028; 95% confidence interval, 1.002–1.055; p = 0.037), along with age, diabetes mellitus, and number of implanted stents. Conclusion: Among patients treated with PCI, the incidence of MACE was significantly higher in those with a higher IABPD (≥10 mmHg) than in those with a lower IABPD (<10 mmHg), which was mainly driven by ischemia-driven target vessel revascularization.