Division of Cardiology, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea.
Division of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea.
PLoS One. 2021 Oct 15;16(10):e0257443. doi: 10.1371/journal.pone.0257443. eCollection 2021.
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).
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.
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.
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.
尽管臂间血压（BP）差异已被认为与心血管事件有关，但肢间 BP 差异的意义尚未得到充分确立。本研究旨在探讨经皮冠状动脉介入治疗（PCI）后臂间和肢间 BP 差异是否具有预后价值。
在这项前瞻性研究中，我们连续纳入了 667 名接受 PCI 的患者。在 PCI 后一天测量臂和腿的 BP。主要结局是随访期间发生的主要不良心血管事件（MACE），包括心源性死亡、急性冠脉综合征、冠状动脉血运重建、卒中和心力衰竭住院。
平均年龄为 64.0±11.1 岁，男性占多数（70.5%）。在平均 3.0 年的随访期间，209 名（31.3%）患者发生了 MACE。与无 MACE 患者相比，MACE 患者的肢间收缩压差异（ILSBPD）明显更高（9.9±12.3 对 7.2±7.5mmHg，P=0.004）。臂间收缩压差异在有和无 MACE 的患者之间无显著差异（P=0.403）。多变量 Cox 回归分析显示，增加的 ILSBPD 与 MACE 的发生独立相关（每增加 5mmHg；风险比，1.07；95%置信区间，1.01-1.14）。多变量分析中，臂间收缩压差异与 MACE 无关。
增加的 ILSBPD 与 PCI 后心血管结局恶化独立相关。由于 ILSBPD 易于测量，它可能有助于对接受 PCI 的患者进行风险分层。
