BACKGROUND: High blood pressure (BP) levels expose patients treated with percutaneous coronary interventions (PCI) to very high risk of 10-year cardiovascular morbidity and mortality. OBJECTIVE: To investigate the role of BP levels at the time of PCI on the risk of in-stent restenosis (ISR). METHODS: We retrospectively included 796 patients previously treated with PCI, who underwent repeated angiography for recurrent angina or reversible myocardial ischemia. Patients were stratified into either case (n = 354) and control (n = 442) groups in the presence or absence of ISR (defined as in-stent diameter stenosis ≥50%). BP levels were measured at the time of first and second procedures. Normal BP levels were defined for <140/90mm Hg. RESULTS: Patients with normal BP showed significantly higher ISR-free survival (Log-rank: 5.937; P = 0.015). Both systolic (HR (95% CI): 0.731 (0.590-0.906)) and systolic/diastolic BP (HR (95% CI): 0.757 (0.611-0.939)) were significantly and independently associated with lower risk of ISR at Cox-regression analysis, adjusted for potential confounding factors, including stent type and concomitant medications. Patients with ISR showed lower rates of normal systolic/diastolic BP values (166 (47%) vs. 254 (57%); P = 0.003) compared to controls. They also received higher stent number (1.40±0.74 vs. 1.24±0.51; P < 0.001) with higher stent length (24.3±15.6 vs. 21.7±13.9mm; P = 0.012), and lower rate of drug-eluting stents (DESs) (210 (48%) vs. 139 (40%); P = 0.025) compared to controls. CONCLUSIONS: Normal BP at the time of PCI is associated with nearly 24% risk reduction of ISR as evaluated in a new angiography in patients with coronary artery diseas

High blood pressure (BP) levels expose patients treated with percutaneous coronary interventions (PCI) to very high risk of 10-year cardiovascular morbidity and mortality.

Blood Pressure Levels at the Time of Percutaneous Coronary Revascularization and Risk of Coronary In-Stent Restenosis / Tocci, Giuliano; Barbato, Emanuele; Coluccia, Roberta; Modestino, Anna; Pagliaro, BENIAMINO ROSARIO; Mastromarino, Vittoria; Giovannelli, Francesca; Berni, Andrea; Volpe, Massimo. - In: AMERICAN JOURNAL OF HYPERTENSION. - ISSN 0895-7061. - (2015), p. hpv131. [10.1093/ajh/hpv131]

Blood Pressure Levels at the Time of Percutaneous Coronary Revascularization and Risk of Coronary In-Stent Restenosis

TOCCI, GIULIANO;Barbato, Emanuele;COLUCCIA, ROBERTA;MODESTINO, ANNA;PAGLIARO, BENIAMINO ROSARIO;MASTROMARINO, VITTORIA;GIOVANNELLI, FRANCESCA;BERNI, Andrea;VOLPE, Massimo
2015

Abstract

High blood pressure (BP) levels expose patients treated with percutaneous coronary interventions (PCI) to very high risk of 10-year cardiovascular morbidity and mortality.
2015
BACKGROUND: High blood pressure (BP) levels expose patients treated with percutaneous coronary interventions (PCI) to very high risk of 10-year cardiovascular morbidity and mortality. OBJECTIVE: To investigate the role of BP levels at the time of PCI on the risk of in-stent restenosis (ISR). METHODS: We retrospectively included 796 patients previously treated with PCI, who underwent repeated angiography for recurrent angina or reversible myocardial ischemia. Patients were stratified into either case (n = 354) and control (n = 442) groups in the presence or absence of ISR (defined as in-stent diameter stenosis ≥50%). BP levels were measured at the time of first and second procedures. Normal BP levels were defined for <140/90mm Hg. RESULTS: Patients with normal BP showed significantly higher ISR-free survival (Log-rank: 5.937; P = 0.015). Both systolic (HR (95% CI): 0.731 (0.590-0.906)) and systolic/diastolic BP (HR (95% CI): 0.757 (0.611-0.939)) were significantly and independently associated with lower risk of ISR at Cox-regression analysis, adjusted for potential confounding factors, including stent type and concomitant medications. Patients with ISR showed lower rates of normal systolic/diastolic BP values (166 (47%) vs. 254 (57%); P = 0.003) compared to controls. They also received higher stent number (1.40±0.74 vs. 1.24±0.51; P < 0.001) with higher stent length (24.3±15.6 vs. 21.7±13.9mm; P = 0.012), and lower rate of drug-eluting stents (DESs) (210 (48%) vs. 139 (40%); P = 0.025) compared to controls. CONCLUSIONS: Normal BP at the time of PCI is associated with nearly 24% risk reduction of ISR as evaluated in a new angiography in patients with coronary artery diseas
coronary artery disease; high blood pressure; hypertension; in-stent restenosis; percutaneous revascularization.
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Blood Pressure Levels at the Time of Percutaneous Coronary Revascularization and Risk of Coronary In-Stent Restenosis / Tocci, Giuliano; Barbato, Emanuele; Coluccia, Roberta; Modestino, Anna; Pagliaro, BENIAMINO ROSARIO; Mastromarino, Vittoria; Giovannelli, Francesca; Berni, Andrea; Volpe, Massimo. - In: AMERICAN JOURNAL OF HYPERTENSION. - ISSN 0895-7061. - (2015), p. hpv131. [10.1093/ajh/hpv131]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/796739
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